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Quality of life evolution after lung cancer surgery in septuagenarians: a prospective study

University Hospital of Antwerp, Edegem, Belgium

Received 9 September 2008; received in revised form 27 January 2009; accepted 30 January 2009.

^_* Corresponding author. Address: Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium. Tel.: +32 3 8213769; fax: +32 3 8214396. (Email: bram.balduyck{at}uza.be).

Objective: To prospectively evaluate quality of life (QoL) evolution after lung cancer surgery in a cohort of septuagenarians with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC13. Methods: Between January 2003 and December 2006, QoL was prospectively recorded in 60 consecutive septuagenarians undergoing lung cancer surgery. Forty-nine lobectomies and 11 pneumonectomies were performed. Questionnaires were administered before surgery and 1, 3, 6 and 12 months postoperatively (MPO) with response rates of 100%, 83%, 87%, 90% and 77%, respectively. Results: After lobectomy, QoL scores returned to baseline 3–6 months after surgery, with the exception of a persistent decrease in physical functioning and an increase in dyspnea within the 12 months follow-up. In the 12 months follow-up period after pneumonectomy, there was no return to baseline in physical, role and social functioning. After pneumonectomy, most quality of life scores returned to baseline at 1-month follow-up, with the exception of dyspnea and general pain, which returned to baseline at 3 and 6 months, respectively. Comparing both resections, significant differences in evolution of physical functioning (6MPO p = 0.045), role functioning (3MPO p = 0.035), social functioning (6MPO p = 0.006, 12MPO p = 0.001) and general pain (6MPO p = 0.037) were reported in favor of lobectomy. Conclusions: The present study documented QoL evolution profiles of septuagenarians after pulmonary surgery. The results indicate that both resections have a major impact on elderly patients, especially physical functioning and dyspnea status. If both resections are compared, lobectomy patients have a more favorable evolution in QoL subscales compared to pneumonectomy.

Key Words: Quality of life • EORTC • QLQ-C30 • QLQ LC-13 • Elderly patients • Septuagenarians • Lobectomy • Pneumonectomy • Lung cancer