PURPOSE: Surgical resection is the most effective treatment of early-stage lung cancer, but can result in post-operative dyspnea. The aim of this study was to determine the prevalence of post-operative dyspnea among a large cohort of long-term early-stage lung cancer survivors and to identify correlates of highest risk.
METHODS: A one-time structured telephone interview was conducted with 336 stage I non-small cell lung cancer patients one to six years following surgical resection (mean 3.5 years). Dyspnea was quantified using the 3-item Baseline Dyspnea Index (self-report version), and performance status was measured by the self-rated Karnofsky scale. A medical record review was also conducted.
RESULTS: Median patient age was 70 years and 212 patients (63%) were female. Lobectomy was the most common procedure, performed in 247 patients (78%). Sublobar resection was performed in 65 patients (20%), and pneumonectomy was performed in 6 patients (2%). Dyspnea, defined as a score of 3 or greater on the self-reported questionnaire, occurred in 60% of patients. In a series of univariate analyses, lower educational level (p<0.0001), current or former smoking (p=0.0070), poorer pre-operative FEV1 (p<0.0001), poorer performance status (p<0.0001), and having a greater number of comorbid medical conditions (p<0.0001) were each associated with higher reported dyspnea. In a multiple regression analysis, poorer pre-operative FEV1 (p=0.0016), poorer performance status (p<0.0001), and a greater number of medical comorbidities (p=0.0018) were independent risk factors for higher reported dyspnea. Smoking status, education level, and the type of surgical procedure were not significant correlates in the multivariate analysis. Dyspnea was not associated with the length of time since surgery.
CONCLUSION: These data identify risk factors for developing post-operative dyspnea among lung cancer patients.
CLINICAL IMPLICATIONS: Identifying risk factors associated with post-operative dyspnea may be helpful in designing future clinical trials and post-operative rehabilitation efforts for patients at highest risk.
DISCLOSURE: Marc Feinstein, No Financial Disclosure Information; No Product/Research Disclosure Information