P1.08-036 Thoracotomy and VATS-Surgery in Local Non-Small Cell Lung Cancer: Differences in Long-Term Health Related Quality of Life

Abstract

Older and more fragile NSCLC patients are operated on through video-assisted thoracic surgery (VATS), compared to thoracotomy. In this study we compare the long-term health related quality of life (HRQoL) among early stage and locally advanced NSCLC patients between these two operative methods. 687 NSCLC patients underwent lobectomy or segmentectomy in our clinic between January 2000 and January 2013, of these 430 were operated before July 2009 and 257 after this. HRQoL questionnaire 15D was sent to patients alive in June 2011 and February 2016 (min. 2 years from operation). After the exclusion of patients with clinically extensive disease (T4, N2 or M1), lacking data (n=5) or receiving neoadjuvant therapy, 345 (191+154) patients were included in the study. 289 (84%) patients answered, 155 from the first and 134 from the second period. Respectively, 42 and 68 respondents had had VATS. The two groups differed in the following features: thoracotomy group had on average more advanced clinical and pathological stage (26% vs 7% and 28% vs 16% stage II & III, respectively), younger age at operation (63.5 vs 66.8 years), and higher frequency of adjuvant therapy (18% vs 5%) (p<0.05 in each). The VATS group scored statistically (p<0.05) and clinically significantly lower on the dimensions Breathing (0.63 vs 0.70), Excretion (0.78 vs 0.85), Usual activities (0.75 vs 0.81), Mental function (0.83 vs 0.89), Depression (0.82 vs 0.88), Distress (0.82 vs 0.88), Vitality (0.76 vs 0.82), Sexual activity (0.72 vs 0.80) and on the 15D score representing overall HRQoL (0.81 vs 0.85) (Figure). Even with less invasive surgical techniques, the older and more comorbid patients seem to have lower long-term HRQoL. This is contrary to previous results of short-term reports.