Impaired quality of life after pneumonectomy: Who is at risk?

Leo, Francesco; Scanagatta, Paolo; Vannucci, Fernando; Brambilla, Daniela; Radice, Davide; Spaggiari, Lorenzo

doi:10.1016/j.jtcvs.2009.05.029

« Previous Next »The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 1 , Pages 49-52, January 2010

Impaired quality of life after pneumonectomy: Who is at risk?

Francesco Leo, MD, PhD
- Thoracic Surgery Department, European Institute of Oncology, Milan, Italy
- Address for reprints: Francesco Leo, MD, PhD, Thoracic Surgery Department, National Cancer Institute, Via Venezian 1, 20100 Milan, Italy.
Paolo Scanagatta, MD
- Thoracic Surgery Department, European Institute of Oncology, Milan, Italy
Fernando Vannucci, MD
- Thoracic Surgery Department, European Institute of Oncology, Milan, Italy
Daniela Brambilla, MA
- Thoracic Surgery Department, European Institute of Oncology, Milan, Italy
Davide Radice, PhD
- Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
Lorenzo Spaggiari, MD, PhD
- Thoracic Surgery Department, European Institute of Oncology, Milan, Italy
- School of Medicine, University of Milan, Italy

Received 5 September 2008; received in revised form 4 May 2009; accepted 31 May 2009. published online 30 July 2009.

Objective

After pneumonectomy, quality of life may be impaired in a proportion of patients because of the presence of symptoms causing severe limitations in daily activities. This is a prospective study on patients who have undergone pneumonectomy for cancer, assessing quality of life modifications 6 months after surgery.

Methods

Beginning in August 2006, candidates for pneumonectomy had their quality of life assessed by the European Organization for Research and Treatment of Cancer questionnaire (QLQ-C30 + LC13) preoperatively and at 1, 3, and 6 months after surgery. Poor quality of life at 6 months was defined as global health values 10% or more below baseline values. The impact of several clinical variables was tested to discover predictors of poor postoperative quality of life.

Results

Forty-one of the 50 patients enrolled in the study had a complete quality of life follow-up by January 2008, representing the population of the study. Six months after pneumonectomy, global health showed a minimal impairment in the whole population (baseline 60.4 ± 26.5, at 6 months 56.3 ± 24.2, P = .15). Ten patients (24.4%) were identified as having poor quality of life at 6 months. Age of 70 years or more was identified as a significant risk factor for poor 6-month quality of life using multivariate analysis (odds ratio, 1.13; 95% confidence interval, 1–1.26). The baseline global health score was the strongest predictor of postoperative global health quality of life (odds ratio, 0.16; 95% confidence interval, 0.02–0.46; P = .0086).

Conclusion

The overall quality of life after pneumonectomy was impaired in 25% of surviving patients at 6 months after surgery; thus, this aspect of recovery should be routinely discussed with patients before pneumonectomy. Patients aged 70 years or more and those with low preoperative quality of life seem to be at risk for unsatisfactory quality of life after surgery.

CTSNet classification: 10

Abbreviation and Acronym: QoL, quality of life