Health-Related Quality of Life in Patients with Non-Small Cell Lung Cancer before and after Surgery - a Comparison between Thoracotomy and Video-Assisted Thoracoscopic Surgery

Abstract

Earlier studies have proven that in patients with non-small cell lung cancer video-assisted thoracoscopic surgery is functionally superior to thoracotomy in terms of perioperative and postoperative complications. The objective of this work was to determine whether there is a difference in health-related quality of life (HRQoL) of patients with non-small cell lung cancer - compared to the German normal population - before and after surgery. Moreover, HRQoL after thoracotomy was compared to HRQoL after video-assisted thoracoscopic surgery (VATS). Based on retrospective data generated during a 7-year period (2010 - 2017), 327 patients with non-small cell lung cancer who underwent therapy were examined. Patients either underwent thoracotomy or video-assisted thoracoscopic surgery. 456 of short form 12 questionnaires were analysed. Via norm-based scoring, and physical and mental component summaries (PCS and MCS) were calculated before and 6, 12, and 24 months after treatment. Using t tests, potential differences in physical and mental component summaries were evaluated between patients and the German normal population as well as between patients after thoractomy and after VATS. Up to 24 months after surgery, the physical dimension of HRQoL is significantly reduced, while the mental component summary does not significantly differ from the German population. Moreover, thoracotomy and VATS gave equivalent values for health-related quality of life. With respect to health-related quality of life, thoracotomy and video-assisted thorascopic surgery are equivalent in the long term. But there was a trend to improvement with both summary scores that might indicate superiority of video-assisted thoracoscopic surgery.