[Quality of life after lobectomy for early stage non-small cell lung cancer--video-assisted thoracoscopic surgery versus minimal incision thoracotomy].

BACKGROUND & OBJECTIVE: Quality of life (QOL) after video-assisted thoracoscopic surgery (VATS) lobectomy for clinical early stage non-small cell lung cancer (NSCLC) has seldom been systematically studied. This study was to compare the QOL in patients with clinical early stage NSCLC after VATS or minimal incision thoracotomy (MIT) lobectomy, and to explore the characteristic of QOL after VATS lobectomy.

METHODS: A prospective randomized controlled trial was conducted. From Mar. 2004 to Mar. 2005, 32 consecutive patients with early stage NSCLC and tumor size of < or =6 cm diagnosed by CT scan were recruited and randomized to VATS group (17 patients) and MIT group(15 patients). Two patients in VAYS group were excluded for conversion to posterolateral thoracotomy because of uncontrolled bleeding and dense pleural adhesion. QOL was assessed using Lung Cancer Symptom Scale (LCSS) before operation and at 1, 3 and 6 months after operation.

RESULTS: There were no significant differences between the 2 groups in age, sex, tumor pathologic stage, tumor size, and postoperative complications. One month after operation, the scores of dyspnea and pain were significantly lower in VATS group than in MIT group (10.9+/-7.4 vs. 17.4+/-9.6, P=0.047; 13.7+/-9.5 vs. 23.0+/-12.2, P=0.028). The score of overall symptom was slightly lower in VATS group than in MIT group (9.7+/-7.2 vs. 16.2+/-10.9, P=0.066). Five major symptoms (appetite, fatigue, cough, dyspnea, and pain) at the VATS group were deteriorated after operation. Appetite, fatigue and cough were deteriorated significantly at 1 month after operation (P<0.05), but returned to nearly preoperative levels at 3 months after operation (P>0.05) except appetite, and all returned to baseline levels at 6 months after operation (P>0.05).

CONCLUSIONS: Compared with MIT lobectomy, VATS will lead to better QOL for the patients with early stage NSCLC. It takes 6 months for the patients to return to preoperative QOL levels after VATS lobectomy.