ZHANG Na 1 , ZHANG Yadi 1 , LEI Chen 1 , LIAO Jia 1 , HU Xiaoqun 1 , XU Na 1 , WEI Xing 1 , LIU Xiaoqing 1 , SHI Qiuling 2 , DAI Wei 1 , WANG Yaqin 1
  • 1. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology, Chengdu, 610041, P. R. China;
  • 2. School of Public Health, Chongqing Medical University, Chongqing, 400016, P. R. China;
DAI Wei, Email: 183738071@qq.com; WANG Yaqin, Email: daiwei@sichuancancer.org
Lung cancer; surgery; symptom burden; functional status; patient-reported outcome
10.7507/1007-4848.202505064
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Objective To determine the symptom burden and functional status of patients with early-stage lung cancer at 4 weeks after discharge, and to investigate the influencing factors. Methods An analysis was conducted on the clinical data of patients with early-stage lung cancer in a multicenter prospective cohort study conducted in six hospitals in China from November 2017 to January 2020. The MD Anderson Symptom Assessment Scale-Lung Cancer Module (MDASI-LC) was used to evaluate symptoms and functions. Binary logistic regression analysis was used to analyze the influencing factors of moderate to severe functional impairment (≥2 points) and moderate to severe symptoms affecting recovery (≥4 points). Results A total of 158 patients were included, including 59 males and 99 females, with an average age of (55.5±9.9) years. At 4 weeks of discharge, the three most severe moderate to severe symptoms were cough (30.4%), shortness of breath (25.3%), and disturbed sleep (22.2%). The proportions of patients with moderate to severe physical and psychological impairment were 53.2% and 38.6%, respectively. Multivariate analysis results showed that shortness of breath was an independent risk factor for moderate to severe postoperative physical impairment [OR=10.12, 95%CI (1.51, 67.60), P=0.017]; cough [OR=5.66, 95%CI (1.52-21.15), P=0.007], pain [OR=12.35, 95%CI (1.21, 126.39), P=0.034], and female sex [OR=4.01, 95%CI (1.10, 14.67), P=0.036] were independent risk factors for moderate to severe psychological impairment; forced expiratory volume in the first second <1.5 L [OR=0.10, 95%CI (0.02, 0.58), P=0.010] and female [OR=2.80, 95%CI (1.17, 6.66), P=0.020] were independent risk factors for moderate to severe shortness of breath; open surgery [OR=6.18, 95%CI (1.54, 24.80), P=0.010] and female [OR=7.33, 95%CI (1.84, 29.20), P=0.005] were independent risk factors for moderate to severe pain. Conclusion Patients with early-stage lung cancer still have a significant symptom burden and functional impairment 4 weeks after discharge. Preoperative attention should be given to patients with poor lung function and female patients. During the operation, open surgery should be avoided as much as possible. Effective management of shortness of breath, pain, and cough symptoms in the postoperative period can promote the functional recovery of patients with early-stage lung cancer.

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