Evaluation Of Quality Of Life Of Patients Submitted To Pulmonary Resection Due To Neoplasia [avaliação Da Qualidade De Vida Em Pacientes Submetidos A Ressecção Pulmonar Por Neoplasia]

Objective: To evaluate the health-related quality of life of patients submitted to resection of the pulmonary parenchyma due to neoplasia. Methods: The Medical Outcomes Study 36-item Short-Form Health Survey was used to evaluate patients in the preoperative period and on postoperative days 30, 90 and 180. We used the GEE statistical model, in which the dependent variable (quality of life) changes for each patient over the course of the evaluation. Independent variables were gender, age, educational level, type of surgery, radiotherapy, chemotherapy, forced vital capacity and 6-minute walk test. The level of significance adopted was 5%. Results: The final study sample comprised 36 patients, 20 of whom were men. Of those 36 patients, 17 were submitted to lobectomy, 10 to pneumonectomy, 6 to segmentectomy, and 3 to bilobectomy. Chemotherapy was used in 15 patients, radiotherapy in 2, and a combination of radiotherapy and chemotherapy in 2. Improved quality of life was seen in the following domains: social (on postoperative day 90); physical/functional (some patients presenting better forced vital capacity and 6-minute walk test performance); and physical (in patients undergoing smaller resections). Lowered quality of life was seen in the following domains: social (for female patients); physical/social (resulting from radiotherapy, chemotherapy or both); and physical/functional (by postoperative day 30). Conclusions: It is important that studies evaluating the various determinants of quality of life, as well as the impact that cancer treatment modalities have on such variables, be conducted. The knowledge provided by such studies can contribute to improving the quality of life of patients undergoing pulmonary resection due to neoplasia.3211015Romano, P.S., Mark, D.H., Patient and hospital characteristics related to in-hospital mortality after lung cancer resection (1992) Chest, 101 (5), pp. 1332-1337Parkin, D.M., Global cancer statistics in the year 2000 (2001) Lancet Oncol, 2 (9), pp. 533-543. , ReviewWelcker, K., Marian, P., Thetter, O., Siebeck, M., Cost and quality of life in thoracic surgery - A health economic analysis in a German center (2003) Thorac Cardiovasc Surg, 51 (5), pp. 260-266(2003) Estimativa Da Incidência e Mortalidade Por Câncer No Brasil 2003, , Brasil. Ministério da Saúde. Instituto Nacional do Câncer. Brasília (DF)Beckles, M.A., Spiro, S.G., Colice, G.L., Rudd, R.M., The physiologic evaluation of patients with lung cancer being considered for resectional surgery (2003) Chest, 123 (1 SUPPL.), pp. 105S-114SBusch, E., Verazin, G., Antkowiak, J.G., Driscoll, D., Takita, H., Pulmonary complications in patients undergoing thoracotomy for lung carcinoma (1994) Chest, 105 (3), pp. 760-766Fernandes, A.L.G., Oliveira, M.A., Avaliação da qualidade de vida na asma (1997) J Pneumol, 23 (3), pp. 48-52Koller, M., Kussman, J., Lorenz, W., Jenkins, M., Voss, M., Arens, E., Symptom reporting in cancer patients: The role of negative effect and experienced social stigma (1996) Cancer, 77 (5), pp. 983-995Ciconelli, R.M., Ferraz, M.B., Santos, W., Meinão, I., Quaresma, M.R., Tradução para a língua portuguesa do questionário genérico de qualidade de vida SF-36 (Brasil SF-36) (1999) Rev Bras Reumatol, 39 (3), pp. 143-150Ware Jr., J.E., Sherbourne, C.D., The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection (1992) Med Care, 30 (6), pp. 473-483Torrington, K.G., Henderson, C.J., Perioperative respiratory therapy (PORT). A program of preoperative risk assessment and individualized postoperative care (1988) Chest, 93 (5), pp. 946-951ATS statement: Guidelines for the six-minute walk test (2002) Am J Respir Crit Care Med, 166 (1), pp. 111-117Brunelli, A., Fianchini, A., Stair climbing test in lung resection candidates with low predict postoperative FEV1 (2003) Chest, 124 (3), p. 1179Garratt, A.M., Ruta, D.A., Abdalla, M.I., Buckingham, J.K., Russell, I.T., The SF36 health survey questionnaire: An outcome measure suitable for routine use within the NHS? (1993) BMJ, 306 (6890), pp. 1440-1444Myrdal, G., Valtysdottir, S., Lambe, M., Stahle, E., Quality of life following lung cancer surgery (2003) Thorax, 58 (3), pp. 194-197Chuter, T.A., Weissman, C., Starker, P.M., Gump, F.E., Effect of incentive spirometry on diaphragmatic function after surgery (1989) Surgery, 105 (4), pp. 488-493Pastó, M., Gea, J., Aguar, M.C., Barreiro, E., Orozco-Levi, M., Félez, M., Broquetas, J., Caracteristicas de la actividad mecánica de los músculos respiratórios durante la tecnica de "respiracion diafragmatica" (2000) Arch Bronconeumol, 36 (1), pp. 13-18Montgomery, D.C., (1991) Design and Analisys of Experiments. 3rd Ed., , New York: John Wiley(1999) The SAS System for Windows (Statistical Analysis System), Versão 8.02, , USA: SAS Institute IncSarna, L., Evangelista, L., Tashkin, D., Padilla, G., Holmes, C., Brecht, M.L., Grannis, F., Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer (2004) Chest, 125 (2), pp. 439-445Handy Jr., J.R., Asaph, J.W., Skokan, L., Reed, C.E., Koh, S., Brooks, G., What happens to patients undergoing lung cancer surgery? Outcomes and quality of life before and after surgery (2002) Chest, 122 (1), pp. 21-30Brunelli, A., Al Refai, M., Monteverde, M., Borri, A., Salati, M., Fianchini, A., Predictors of exercise oxygen desaturation following major lung resection (2003) Eur J Cardiothorac Surg, 24 (1), pp. 145-148Patel, R.L., Townsend, E.R., Fountain, S.W., Elective pneumonectomy: Factors associated with morbidity and operative mortality (1992) Ann Thorac Surg, 54 (1), pp. 84-88Cykert, S., Kissling, G., Hansen, C.J., Patient preferences regarding possible outcomes of lung resection: What outcomes should preoperative evaluations target? (2000) Chest, 117 (6), pp. 1551-1559Fiedler, R., Neef, H., Rosendahl, W., Functional outcome and quality of life at least 6 months after pneumonectomy - Effect of operation, adjuvant therapy, tumor stage, sex, type of pneumonia and recurrence (1999) Pneumologie, 53 (1), pp. 45-9.Id:GerLubbe, A.S., Krischke, N.R., Dimeo, F., Forkel, S., Petermann, F., Health-related quality of life and pulmonary function in lung cancer patients undergoing medical rehabilitation treatment (2001) Wien Med Wochenschr, 151 (1-2), pp. 29-34Zieren, H.U., Müller, J.M., Hamberger, U., Pichlmaier, H., Quality of life after surgical therapy of bronchogenic carcinoma (1996) Eur J Cardiothorac Surg, 10 (4), pp. 233-237Buccheri, G.F., Ferrigno, D., Tamburini, M., Brunelli, C., The patient's perception of his own quality of life might have an adjunctive prognostic significance in lung cancer (1995) Lung Cancer, 12 (1-2), pp. 45-58Montarezi, A., Milroy, R., Hole, D., McEwen, J., Gillis, C.R., How quality of life data contribute to our understanding of cancer patients' experiences? A study of patients with lung cancer (2003) Qual Life Res., 12 (2), pp. 157-166Celli, B.R., Chronic respiratory failure after lung resection: The role of pulmonary rehabilitation (2004) Thorac Surg Clin, 14 (3), pp. 417-428. , Revie