Surgery is the most effective treatment for early-stage lung cancer; however, it poses a higher physical burden than other treatment options. Therefore, understanding the perioperative course of patients is important. Using the Short Form Health Survey 36, we prospectively measured the physical quality of life of patients who underwent anatomical pulmonary resection for non-small cell lung cancer at Shonan Kamakura General Hospital, Kanagawa, Japan (n = 87). In the preoperative setting, patients who had lower performance status and lived alone had significantly worse physical quality of life scores on multivariate analysis (regression coefficient (95% confidence interval), −9.37 (−13.43–−5.32) and −10.22 (−13.74–−7.40), respectively,p< 0.0001 for both). At 6 months postoperatively, patients who stopped smoking within 1 year preoperatively (stopped smoking within 1 year vs. remote or never smokers, 41.0 ± 10.5 vs. 48.6 ± 7.2,p= 0.002), had lower performance status (0 vs. 1–2, 49.3 ± 6.6 vs. 38.6 ± 9.6,p< 0.0001), lived alone (living alone vs. living with somebody, 41.6 ± 9.7 vs. 48.1 ± 7.9,p= 0.021), and had higher comorbid burden (Charlson comorbidity index <3 vs. ≥3, 48.2 ± 6.9 vs. 39.1 ± 14.7,p= 0.003) had significantly worse physical quality of life scores on univariate analysis. More recent smoking (regression coefficient (95% confidence interval), −4.90 (−8.78–1.0),p= 0.014), lower performance status (8.90 (5.10–12.70),p< 0.0001), living alone (5.76 (1.39–10.13),p= 0.01), and higher comorbid burden (−6.94 (−11.78–−2.10),p= 0.006) were significant independent predictors of worse postoperative physical quality of life on multivariate analysis. Therefore, patients with these conditions might need additional support to maintain their physical condition after anatomical lung cancer surgery.
手术是早期肺癌最有效的治疗方式，但其带来的生理负担高于其他治疗方案。因此，了解患者的围手术期病程具有重要意义。本研究采用简明健康调查量表36项，前瞻性评估了在日本神奈川县湘南镰仓综合医院接受解剖性肺切除术的非小细胞肺癌患者（n=87）的生理生活质量。术前多变量分析显示，体能状态较差及独居患者的生理生活质量评分显著降低（回归系数（95%置信区间）分别为-9.37（-13.43至-5.32）和-10.22（-13.74至-7.40），两者p<0.0001）。术后6个月单变量分析表明，术前1年内戒烟（1年内戒烟者vs.长期戒烟或从不吸烟者：41.0±10.5 vs. 48.6±7.2，p=0.002）、体能状态较差（0级vs.1-2级：49.3±6.6 vs. 38.6±9.6，p<0.0001）、独居（独居者vs.与他人同住者：41.6±9.7 vs. 48.1±7.9，p=0.021）及合并症负担较重（查尔森合并症指数<3 vs.≥3：48.2±6.9 vs. 39.1±14.7，p=0.003）患者的生理生活质量评分显著恶化。多变量分析进一步证实，近期吸烟（回归系数（95%置信区间）：-4.90（-8.78至-1.0），p=0.014）、体能状态较差（8.90（5.10-12.70），p<0.0001）、独居（5.76（1.39-10.13），p=0.01）及较高合并症负担（-6.94（-11.78至-2.10），p=0.006）是术后生理生活质量恶化的独立预测因素。因此，具有这些特征的患者在接受解剖性肺癌手术后可能需要额外支持以维持其生理状态。
肿瘤(癌症)患者之家