Cohort study investigating evolution and factors associated with dyspnoea after anatomic lung resection

Area of Science:

• Pulmonology
• Thoracic Surgery
• Oncology

Background:

• Dyspnoea is a common complication after surgical resection for non-small cell lung cancer (NSCLC).
• The long-term impact of postoperative dyspnoea on quality of life and treatment outcomes is not well understood.
• Current understanding of risk factors for persistent dyspnoea post-lung resection is limited.

Purpose of the Study:

• To evaluate the long-term evolution of patient-reported dyspnoea following anatomic lung resection for NSCLC.
• To identify patient-specific and surgical factors associated with clinically meaningful changes in dyspnoea.

Main Methods:

• A single-centre, longitudinal cohort study of 131 patients undergoing anatomic lung resection for NSCLC.
• Dyspnoea was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Lung Cancer-specific Dyspnoea Scale (LCS).
• Multivariable regression analysis identified factors associated with clinically meaningful perioperative changes in dyspnoea at 6-12 months post-surgery.

Main Results:

• Mean LCS scores increased from 12.6 preoperatively to 17.9 at 6-12 months post-surgery.
• 31% of patients experienced a clinically meaningful increase (>10 points) in dyspnoea.
• Female sex was the only patient factor associated with increased postoperative dyspnoea (P=0.046).
• Segmentectomy was associated with a lower risk of increased dyspnoea compared to larger resections (34% vs 9%, P=0.014).

Conclusions:

• A significant proportion of patients experience clinically meaningful dyspnoea after lung resection.
• Postoperative dyspnoea progression is difficult to predict using baseline factors alone.
• Patient-reported outcomes and symptom monitoring are crucial for managing dyspnoea post-lung surgery.