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Eur J Cardiothorac Surg 2006;30:548-553
© 2006 Elsevier Science NL

Preoperative psychological global well being index (PGWBI) predicts postoperative quality of life for patients with non-small cell lung cancer managed with thoracic surgery

^a Faculty of Medicine (Université de la Méditerranée)—Assistance Publique Hôpitaux de Marseille, Department of Thoracic Oncology, Hôpital Sainte-Marguerite, 13274 Marseille Cedex 09, France
^b Faculty of Medicine (Université de la Méditerranée)—Laboratoire de Santé Publique, Evaluation hospitalière—Mesure de la Santé perçue (EA 3279), 13385 Marseille Cedex 05, France
^c Faculty of Medicine (Université de la Méditerranée)—Assistance Publique Hôpitaux de Marseille, Department of Thoracic Surgery, Hôpital Sainte-Marguerite, 13274 Marseille Cedex 09, France

Received 10 February 2006; received in revised form 29 May 2006; accepted 31 May 2006.

^_* Corresponding author. Address: Service d’Oncologie Thoracique, Fédération des Maladies Respiratoires, Hôpital Sainte-Marguerite, 270, Bd de Sainte-Marguerite, 13274 Marseille Cedex 09, France. Tel.: +33 491 74 47 36; fax: 33 491 74 55 24 (Email: fabrice.barlesi{at}mail.ap-hm.fr).

Objective: Non-small cell lung cancer (NSCLC) patients surgically treated often experienced a postoperative disability related to the surgery but did not benefit from a long-term survival advantage (postoperative death and relapse). Therefore, improvement of quality of life (QOL) for all NSCLC patients surgically treated is necessary and the assessment of factors influencing the short-term postoperative QOL is required. Therefore, a prospective study to assess the value of the psychological global well being index (PGWBI) to predict short-term postoperative QOL was conducted. Patients and methods: Prospective study in Academic Hospital's departments of thoracic oncology and surgery. Socio-demographic and clinical characteristics as well as PGWBI scores of 110 NSCLC patients referred for thoracic surgery were prospectively compared to postoperative QOL evaluated by the mean of the EORTC QLQ-C30 and LC13 questionnaires, completed before hospital discharge. Results: Eighty-four patients completed the postoperative QOL questionnaires. In the univariate analysis, most of the PGWBI scores significantly correlated with the postoperative QOL. Also, patients living alone presented with a significantly higher risk of experiencing a poor postoperative QOL. In the multivariate analysis, patients showing a lower preoperative global health status as evaluated through the PGWBI experienced a statistically significant lower postoperative global QOL (hazard ratio (HR) = 1.39, 95% confidence interval (CI) 1.12–1.74, p = 0.003) as well as a reduced physical (HR = 1.32, 95% CI 1.09–1.60, p = 0.004) and emotional (HR = 1.21, 95% CI 1.06–1.39, p = 0.004) functions. Conclusions: A simple assessment of patients at higher risk of a poor short-term postoperative QOL could be easily performed preoperatively, taking into account certain socio-demographic factors and the results of the QOL assessment using the PGWBI.

Key Words: Lung cancer • Surgery • Quality of life • PGWBI • EORTC QLQ-C30

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