Early Post-discharge Pain Trajectories After Thoracoscopic Sublobar Resection for Stage IA Non-small Cell Lung Cancer

Thoracoscopic sublobar resection is emerging as a main treatment option for early-stage non-small cell lung cancer (NSCLC). This study aimed to determine whether distinct early post-discharge pain trajectories could be identified in patients with stage IA NSCLC undergoing thoracoscopic sublobar resection.

The data were collected from a longitudinal prospective observational cohort (CN-PRO-Lung 3). Pain severity was rated using a 0-10 scale, with assessments conducted before surgery and daily after discharge for up to 30 days. Post-discharge pain trajectories were identified using the latent class mixed model. Potential risk factors associated with different pain trajectory were explored, including preoperative clinical characteristics, body composition metrics derived from chest computed tomography, surgical methods, and postoperative clinical outcomes.

A total of 439 patients were selected in the trajectory analysis. One trajectory comprised 65 patients (14.8%, unrecovered group) who experienced persistent moderated post-discharge pain, while the other comprised 374 patients (85.2%, recovered group) with mild post-discharge pain and a declining trend. The independent predictors for the unrecovered post-discharge pain trajectory included the subcutaneous fat index (odds ratio [OR] 1.031, 95% confidence interval [CI] 1.007-1.055, p = 0.010), preoperative pain severity (OR 1.428, 95% CI 1.102-1.851, p = 0.007), and hospital stay (OR 1.166, 95% CI 1.012-1.345, p = 0.034).

Patients with stage IA NSCLC undergoing thoracoscopic sublobar resection had two different early post-discharge pain trajectories. The higher subcutaneous fat index, more severe preoperative pain level, and longer hospital stay were associated with the unrecovered post-discharge pain.