Preoperative Lung Function is Associated with Patient Reported Outcomes After Lung Cancer Surgery.

BACKGROUND Patient quality of life (QOL) is a critical outcomes measure in lung cancer surgery. Patient reported outcomes (PRO) provide valuable insight into the patient experience and allow measurement of pre- and post-operative QOL. Our objective was to determine which clinical factors predict differences in QOL, as measured by patient-reported physical function and pain intensity among patients undergoing minimally-invasive lung cancer surgery. METHODS PRO surveys assessing physical function and pain intensity were conducted using instruments from the NIH Patient Reported Outcome Measurement Information System (PROMIS). PRO surveys were administered to patients undergoing minimally-invasive lung cancer resections at preoperative, one and six month postoperative time points, in an academic institution. Linear mixed-effects regression models were constructed to assess the association between clinical variables on PRO scores over time. RESULTS A total of 123 patients underwent a thoracoscopic lung resection for cancer. Mean age of the cohort was 67±9.6, 43% were male, and 80% were Caucasian. When comparing clinical variables with PRO scores after surgery, lower DLCO was associated with significantly worse physical function (p<0.01) and greater pain intensity scores (p<0.01) at 6 months, with no differences identified at 1 month. No other studied clinical factor was associated with significant differences in PRO scores. CONCLUSIONS Low preoperative DLCO was associated with significant decreases in PRO following minimally-invasive lung cancer surgery. DLCO may be of utility in identifying patients who experience greater decline in QOL after surgery and for guiding surgical decision-making.