Postoperative Symptom Burden in Patients Undergoing Lung Cancer Surgery

Overview

Journal J Pain Symptom Manage

Publisher Elsevier

Specialties Critical Care
Pharmacology
Psychiatry

Date 2022 Jun 6

PMID 35659636

Authors

Aurelie Merlo

Rebecca Carlson

John Espey 3rd

Brittney M Williams

Pranav Balakrishnan

Sarah Chen

Lauren Dawson

Daniel Johnson

Julia Brickey

Cecilia Pompili

Gita N Mody

Affiliations

Soon will be listed here.

Abstract

Context: Previous studies on quality of life (QOL) after lung cancer surgery have identified a long duration of symptoms postoperatively. We first performed a systematic review of QOL in patients undergoing surgery for lung cancer. A subgroup analysis was conducted focusing on symptom burden and its relationship with QOL.

Objective: To perform a qualitative review of articles addressing symptom burden in patients undergoing surgical resection for lung cancer.

Methods: The parent systematic review utilized search terms for symptoms, functional status, and well-being as well as instruments commonly used to evaluate global QOL and symptom experiences after lung cancer surgery. The articles examining symptom burden (n = 54) were analyzed through thematic analysis of their findings and graded according to the Oxford Centre for Evidence-based Medicine rating scale.

Results: The publication rate of studies assessing symptom burden in patients undergoing surgery for lung cancer have increased over time. The level of evidence quality was 2 or 3 for 14 articles (cohort study or case control) and level of 4 in the remaining 40 articles (case series). The most common QOL instruments used were the Short Form 36 and 12, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, and the Hospital Anxiety and Depression Score. Thematic analysis revealed several key findings: 1) lung cancer surgery patients have a high symptom burden both before and after surgery; 2) pain, dyspnea, cough, fatigue, depression, and anxiety are the most commonly studied symptoms; 3) the presence of symptoms prior to surgery is an important risk factor for higher acuity of symptoms and persistence after surgery; and 4) symptom burden is a predictor of postoperative QOL.

Conclusion: Lung cancer patients undergoing surgery carry a high symptom burden which impacts their QOL. Measurement approaches use myriad and heterogenous instruments. More research is needed to standardize symptom burden measurement and management, with the goal to improve patient experience and overall outcomes.

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Beyond surgery: Overcoming postoperative depression in cancer patients.

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Efficacy of a smartphone application assisting home-based rehabilitation and symptom management for patients with lung cancer undergoing video-assisted thoracoscopic lobectomy: a prospective, single-blinded, randomised control trial (POPPER study).

Lv C, Lu F, Zhou X, Li X, Yu W, Zhang C Int J Surg. 2024; 111(1):597-608.

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