PMID- 25500100 OWN - NLM STAT- MEDLINE DCOM- 20150604 LR - 20181113 IS - 1097-685X (Electronic) IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 149 IP - 3 DP - 2015 Mar TI - Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer: results from the ACOSOG Z4032 (Alliance) multicenter randomized trial. PG - 718-25; discussion 725-6 LID - S0022-5223(14)01779-6 [pii] LID - 10.1016/j.jtcvs.2014.11.003 [doi] AB - BACKGROUND: Prior studies have suggested that low baseline quality-of-life (QOL) scores predict worse survival in patients undergoing lung cancer surgery. However, these studies involved average-risk patients undergoing lobectomy. We report QOL results from a multicenter trial, American College of Surgeons Oncology Group Z4032, which randomized high-risk operable patients to sublobar resection (SR), or SR with brachytherapy, and included longitudinal QOL assessments. METHODS: Global QOL, using the 36-item Short-Form Health Survey (SF36), and the dyspnea score from the University of California, San Diego Shortness of Breath Questionnaire (SOBQ) scale, was measured at baseline, 3, 12, and 24 months. SF36 physical component summary (PCS) and mental component summary (MCS) scores were standardized and adjusted for age and gender normals, with scores <50 indicating below-average health status. SOBQ scores were transformed to a 0-100 (poor-excellent) scale. Aims were to: (1) determine the impact of baseline scores on recurrence-free survival, overall survival, and 30-day adverse events (AEs); and (2) identify subgroups (surgical approach, resection type. tumor location, tumor size, respiratory function) with a >/= 10-point decline or improvement in QOL after SR. RESULTS: Two hundred twelve eligible patients were included. There were no significant differences in baseline QOL scores between arms. Median baseline PCS, MCS, and SOBQ scores were 42.7, 51.1, and 70.8, respectively. There were no differences in grade-3+ AEs, overall survival, or recurrence-free survival in patients with baseline scores median values, except for a significantly worse overall survival for patients with baseline SOBQ scores /= 10-point decline in SOBQ scores with segmentectomy compared with wedge resection (40.5% vs 21.9%, P = .03) at 12 months, with thoracotomy versus video-assisted thoracic surgery (VATS) (38.8% vs 20.4%, P = .03) at 12 months, and T1b versus T1a tumors (46.9% vs 23.5%, P = .020) at 24 months. A >/= 10-point improvement in PCS score was seen at 3 months with VATS versus thoracotomy (16.5% vs 3.6%, P = .02). CONCLUSIONS: In high-risk operable patients, poor baseline QOL scores were not predictive for worse overall or recurrence-free survival, or for higher risk for AEs following SR. VATS was associated with improvement in physical function at 3 months, and improved dyspnea scores at 12 months, lending support for the preferential use of VATS when SR is undertaken. CI - Copyright (c) 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. FAU - Fernando, Hiran C AU - Fernando HC AD - Boston Medical Center, Boston, Mass. Electronic address: Hiran.Fernando@bmc.org. FAU - Landreneau, Rodney J AU - Landreneau RJ AD - University of Pittsburgh, Pittsburgh, Pa. FAU - Mandrekar, Sumithra J AU - Mandrekar SJ AD - Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minn. FAU - Nichols, Francis C AU - Nichols FC AD - Mayo Clinic, Rochester, Minn. FAU - DiPetrillo, Thomas A AU - DiPetrillo TA AD - Rhode Island Hospital, Providence, RI. FAU - Meyers, Bryan F AU - Meyers BF AD - Washington University of St Louis, St Louis, Mo. FAU - Heron, Dwight E AU - Heron DE AD - University of Pittsburgh, Pittsburgh, Pa. FAU - Hillman, Shauna L AU - Hillman SL AD - Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minn. FAU - Jones, David R AU - Jones DR AD - University of Virginia, Charlottesville, Va. FAU - Starnes, Sandra L AU - Starnes SL AD - University of Cincinnati, Cincinnati, Ohio. FAU - Tan, Angelina D AU - Tan AD AD - Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minn. FAU - Daly, Benedict D T AU - Daly BD AD - University of Pittsburgh, Pittsburgh, Pa. FAU - Putnam, Joe B AU - Putnam JB AD - Vanderbilt University Medical Center, Nashville, Tenn. CN - Alliance for Clinical Trials in Oncology LA - eng SI - ClinicalTrials.gov/NCT00107172 GR - CA33601/CA/NCI NIH HHS/United States GR - CA076001/CA/NCI NIH HHS/United States GR - U10 CA031946/CA/NCI NIH HHS/United States GR - U10 CA033601/CA/NCI NIH HHS/United States GR - U10 CA180821/CA/NCI NIH HHS/United States GR - U10 CA076001/CA/NCI NIH HHS/United States GR - U10 CA180833/CA/NCI NIH HHS/United States GR - CA31946/CA/NCI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20141113 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM CIN - J Thorac Cardiovasc Surg. 2015 Mar;149(3):663-4. PMID: 25598527 MH - Aged MH - Aged, 80 and over MH - Brachytherapy MH - Disease Progression MH - Disease-Free Survival MH - Female MH - Health Status MH - Humans MH - Kaplan-Meier Estimate MH - Longitudinal Studies MH - Lung Neoplasms/mortality/pathology/psychology/*surgery MH - Male MH - Middle Aged MH - Neoplasm Recurrence, Local MH - Neoplasm Staging MH - Pneumonectomy/adverse effects/mortality/*psychology MH - Prospective Studies MH - *Quality of Life MH - Radiotherapy, Adjuvant MH - Risk Assessment MH - Risk Factors MH - Surveys and Questionnaires MH - Time Factors MH - Treatment Outcome MH - United States PMC - PMC4807969 MID - NIHMS642190 OTO - NOTNLM OT - lung cancer OT - quality of life OT - surgery EDAT- 2014/12/17 06:00 MHDA- 2015/06/05 06:00 PMCR- 2016/03/25 CRDT- 2014/12/16 06:00 PHST- 2014/04/04 00:00 [received] PHST- 2014/09/10 00:00 [revised] PHST- 2014/11/04 00:00 [accepted] PHST- 2014/12/16 06:00 [entrez] PHST- 2014/12/17 06:00 [pubmed] PHST- 2015/06/05 06:00 [medline] PHST- 2016/03/25 00:00 [pmc-release] AID - S0022-5223(14)01779-6 [pii] AID - 10.1016/j.jtcvs.2014.11.003 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2015 Mar;149(3):718-25; discussion 725-6. doi: 10.1016/j.jtcvs.2014.11.003. Epub 2014 Nov 13.