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R. Schwartz



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    P1.06 - Poster Session/ Screening and Early Detection (ID 218)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Screening and Early Detection
    • Presentations: 1
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      P1.06-014 - Impact of Surgery for Stage I Non-Small Cell Lung Cancer on Quality of Life (ID 1586)

      09:30 - 09:30  |  Author(s): R. Schwartz

      • Abstract
      • Slides

      Background:
      The literature is mixed regarding the impact of lung cancer surgery on physical and mental health quality of life (QoL)[1-4]. Some studies have found an improvement in QoL post surgery[1] while others have indicated a decrease in various aspects of QoL[2,3]. Further, the impact on QoL is often dependent on numerous factors such as type of surgery. The current study aims to assess the impact of surgery on both physical and mental health QoL in screening-diagnosed patients with early stage lung cancer, an under-studied population.

      Methods:
      SF-12 QoL indicators were collected from 86 participants (40 women, 46 men) at baseline CT screening and one-year follow up post-surgery for clinical stage IA non-small cell lung cancer. 69 had lobectomy and 17 had sublobar resection. Average time of follow up was 12 months since surgery (SD: 1.5 months; range: 9-15 months post surgery). Univariate and multivariate analyses were performed to examine the difference in physical (PHC) and mental (MHC) health component scores of the SF-12 before and after surgery using the Wilcoxon signed rank and Mann Whitney tests.

      Results:

      SF-12 Quality of Life Scores Pre and Post Surgery
      ALL M(SD) MALE M(SD) FEMALE M(SD) LIMITED RESECTION M(SD) LOBECTOMY M(SD)
      PHC Baseline (Pre-Surgery) 49.4(6.8) 49.8(5.8) 49.0(7.8) 47.8 (7.8) 49.8(6.5)
      Post-Surgery 48.7(7.1) 48.5(7.7) 49.0(6.4) 50.3(6.3) 48.3(7.2)
      Difference (Post-Pre) -0.7(7.6) -1.3(7.5) 0.0(7.6) 2.5*(6.0) -1.5(7.7)
      MHC Baseline (Pre-Surgery) 53.7(8.6) 55.5(7.6) 51.7(9.3) 52.3(13.4) 54.0(7.1)
      Post-SurgerY 55.8(8.2) 57.3(8.1) 54.1(8.2) 55.7(6.3) 55.8(8.7)
      Difference (Post-Pre) 2.0*(9.6) 1.7*(8.5) 2.4*(10.9) 2.9(10.7) 1.8(9.4)
      *p<.05
      There was no significant change in PHC post-surgery (Wilcoxon signed rank test, S=-216, p=0.32), but MHC significantly improved from baseline to post-surgery (S=527, P=0.01). Mean MHC was significantly higher among males as compared to females at both baseline (Chi-square=3.95, p=.047) and post-surgery (Chi-square=4.23, p=.039) and after controlling for age, ethnicity, and education, while no differences in PHC was observed. Further, there was an improvement in PCS score post-surgery among participants who underwent limited resection while a decrease in PCS score was observed among those who underwent lobectomy. The change in PCS score was significantly different between type of surgery (t=-2.01, p=0.048). After controlling for demographics, the difference was borderline significant (F=3.62, p=0.06).

      Conclusion:
      Surgery for early stage lung cancer was associated with an increase in mental health QoL one year after surgery, however, physical health QoL was not affected by surgery overall, but it did marginally improve among participants who underwent limited resection as compared to lobectomy. Further, although mental health QoL improved for both males and females, females had lower mental health QoL as compared to males at both time points. Current study findings have implications for lung cancer health professionals regarding how to most effectively present the possible impacts of surgery on the QoL of this subset of patients in which disease has not yet significantly progressed.

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