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Pompili C, Omar S, Ilyas MH, Velikova G, Dalmia S, Valuckiene L, Alexopoulos P, Brunelli A. Patient-reported Physical Function Is Associated With Survival After Lung Resection for Non-Small Cell Lung Cancer. Ann Thorac Surg 2023; 116:563-569. [PMID: 36270391 DOI: 10.1016/j.athoracsur.2022.09.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND We investigated the association between preoperative quality of life and long-term survival in patients undergoing surgical resection for non-small cell lung cancer. METHODS Retrospective analysis was conducted on 388 consecutive patients who completed the quality of life assessment through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and lung cancer specific module (LC13), before anatomic lung resection for non-small cell lung cancer (2014-2018). Survival distribution was estimated by the Kaplan-Meier method. Cox proportional hazards regression and competing risk regression analyses were used to assess the independent association of preoperative patient-reported outcomes with overall and cancer-specific survival. RESULTS Higher score in patient-reported physical functioning was significantly associated with longer overall survival. Factors significantly associated with poorer overall survival remained older age (P = .005), low body mass index (P = .007), male sex (P < .001), and nodal involvement (P = .007). Competing regression analysis found that worse baseline lung cancer-specific dyspnea (P = .03), low body mass index (P = .01), worse performance status (P = .03), and lymph node involvement (P = .01) were significantly associated with poorer cancer-specific survival. CONCLUSIONS Higher patient-reported physical function score was associated with longer overall survival after resection. Our study highlights the significance of routinely collecting quality of life data to aid preoperative decision making in non-small cell lung cancer.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centered Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom; Thoracic Surgery Unit, University Hospital, Verona, Italy.
| | - Salma Omar
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Galina Velikova
- Section of Patient Centered Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - Sanjush Dalmia
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Laura Valuckiene
- Division of Thoracic Surgery, St James's University Hospital, Leeds, United Kingdom
| | | | - Alessandro Brunelli
- Division of Thoracic Surgery, St James's University Hospital, Leeds, United Kingdom
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2
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Merlo A, Carlson R, Espey J, Williams BM, Balakrishnan P, Chen S, Dawson L, Johnson D, Brickey J, Pompili C, Mody GN. Postoperative Symptom Burden in Patients Undergoing Lung Cancer Surgery. J Pain Symptom Manage 2022; 64:254-267. [PMID: 35659636 PMCID: PMC10744975 DOI: 10.1016/j.jpainsymman.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 11/20/2022]
Abstract
CONTEXT Previous studies on quality of life (QOL) after lung cancer surgery have identified a long duration of symptoms postoperatively. We first performed a systematic review of QOL in patients undergoing surgery for lung cancer. A subgroup analysis was conducted focusing on symptom burden and its relationship with QOL. OBJECTIVE To perform a qualitative review of articles addressing symptom burden in patients undergoing surgical resection for lung cancer. METHODS The parent systematic review utilized search terms for symptoms, functional status, and well-being as well as instruments commonly used to evaluate global QOL and symptom experiences after lung cancer surgery. The articles examining symptom burden (n = 54) were analyzed through thematic analysis of their findings and graded according to the Oxford Centre for Evidence-based Medicine rating scale. RESULTS The publication rate of studies assessing symptom burden in patients undergoing surgery for lung cancer have increased over time. The level of evidence quality was 2 or 3 for 14 articles (cohort study or case control) and level of 4 in the remaining 40 articles (case series). The most common QOL instruments used were the Short Form 36 and 12, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, and the Hospital Anxiety and Depression Score. Thematic analysis revealed several key findings: 1) lung cancer surgery patients have a high symptom burden both before and after surgery; 2) pain, dyspnea, cough, fatigue, depression, and anxiety are the most commonly studied symptoms; 3) the presence of symptoms prior to surgery is an important risk factor for higher acuity of symptoms and persistence after surgery; and 4) symptom burden is a predictor of postoperative QOL. CONCLUSION Lung cancer patients undergoing surgery carry a high symptom burden which impacts their QOL. Measurement approaches use myriad and heterogenous instruments. More research is needed to standardize symptom burden measurement and management, with the goal to improve patient experience and overall outcomes.
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Affiliation(s)
- Aurelie Merlo
- Department of Surgery (A.M., J.E., B.M.W., G.N.M.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca Carlson
- University Libraries (R.C.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John Espey
- Department of Surgery (A.M., J.E., B.M.W., G.N.M.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brittney M Williams
- Department of Surgery (A.M., J.E., B.M.W., G.N.M.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Sarah Chen
- Department of Surgery (S.C.), Medical University of South Carolina, South Carolina, USA
| | - Lauren Dawson
- University of North Carolina at Chapel Hill School of Medicine (L.D., D.J., J.B.), Chapel Hill, North Carolina, USA
| | - Daniel Johnson
- University of North Carolina at Chapel Hill School of Medicine (L.D., D.J., J.B.), Chapel Hill, North Carolina, USA
| | - Julia Brickey
- University of North Carolina at Chapel Hill School of Medicine (L.D., D.J., J.B.), Chapel Hill, North Carolina, USA
| | - Cecilia Pompili
- Section of Patient Centred Outcomes Research (C.P.), Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK
| | - Gita N Mody
- Department of Surgery (A.M., J.E., B.M.W., G.N.M.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center (G.N.M.), University of North Carolina, Chapel Hill, North Carolina, USA.
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3
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Pompili C, Scheenstra B, Zirafa C, Melfi F, De Rosis S, Vainieri M, Lau K, Sardari Nia P. The role of patient-reported outcome and experience measures in cardio-thoracic surgery. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2022; 38:ivae025. [PMID: 38490192 PMCID: PMC11032704 DOI: 10.1093/icvts/ivae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/08/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024]
Affiliation(s)
| | - Bart Scheenstra
- Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands
| | - Carmelina Zirafa
- Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Franca Melfi
- Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Sabina De Rosis
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Milena Vainieri
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Kelvin Lau
- Barts Thorax Centre, St Bartholomew Hospital, London, UK
| | - Peyman Sardari Nia
- Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands
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Pompili C, McLennan Battleday F, Chia WL, Chaudhuri N, Kefaloyannis E, Milton R, Papagiannopoulos K, Tcherveniakov P, Brunelli A. Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer. Eur J Cardiothorac Surg 2021; 59:116-121. [PMID: 33057709 DOI: 10.1093/ejcts/ezaa245] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to assess whether quality of life (QoL) scales are associated with postoperative length of stay (LoS) following video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer. METHODS This is a single-centre retrospective analysis on 250 consecutive patients submitted to VATS lobectomies (233) or segmentectomies (17) over a period of 3 years. QoL was assessed in all patients by the self-administration of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 questionnaire. The individual QoL scales were tested for possible association with LoS along with other objective baseline and surgical parameters using univariable and multivariable analyses. RESULTS Thirty-day cardiopulmonary and mortality rates were 22% and 2.4%. The median LoS was 4 days [interquartile range (IQR) 3-7]. Fifty-one (20%) patients remained in hospital longer than 7 days after surgery (upper quartile). General health [global health score (GHS)] (P = 0.019), physical function (P = 0.014) and role functioning (P = 0.016) scales were significantly worse in patients with prolonged stay. They were highly correlated between each other and tested separately in different logistic regression analyses. The best model resulted the one containing GHS (P = 0.032) along with age, low force expiratory volume in 1 s and carbon monoxide lung diffusion capacity and history of cerebrovascular disease. Fifty-nine patients had GHS <58 (lower interquartile value). Thirty-one percent of them experienced prolonged hospital stay (vs 17% of those with higher GHS, P = 0.027). CONCLUSIONS Preoperative patient-reported QoL was associated with prolonged postoperative hospital stay. Baseline QoL status should be taken into consideration to implement psychosocial supportive programmes in the context of enhanced recovery after surgery.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK.,Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, UK
| | - Finn McLennan Battleday
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK
| | - Wei Ling Chia
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK
| | - Nilanjan Chaudhuri
- Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, UK
| | | | - Richard Milton
- Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, UK
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5
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Pompili C, Trevis J, Patella M, Brunelli A, Libretti L, Novoa N, Scarci M, Tenconi S, Dunning J, Cafarotti S, Koller M, Velikova G, Shargall Y, Raveglia F. European Society of Thoracic Surgeons electronic quality of life application after lung resection: field testing in a clinical setting. Interact Cardiovasc Thorac Surg 2021; 32:911-920. [PMID: 33909903 DOI: 10.1093/icvts/ivab030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Technology has the potential to assist healthcare professionals in improving patient-doctor communication during the surgical journey. Our aims were to assess the acceptability of a quality of life (QoL) application (App) in a cohort of cancer patients undergoing lung resections and to depict the early perioperative trajectory of QoL. METHODS This multicentre (Italy, UK, Spain, Canada and Switzerland) prospective longitudinal study with repeated measures used 12 lung surgery-related validated questions from the European Organisation for Research and Treatment of Cancer Item Bank. Patients filled out the questionnaire preoperatively and 1, 7, 14, 21 and 28 days after surgery using an App preinstalled in a tablet. A one-way repeated measures analysis of variance was run to determine if there were differences in QoL over time. RESULTS A total of 103 patients consented to participate in the study (83 who had lobectomies, 17 who had segmentectomies and 3 who had pneumonectomies). Eighty-three operations were performed by video-assisted thoracoscopic surgery (VATS). Compliance rates were 88%, 90%, 88%, 82%, 71% and 56% at each time point, respectively. The results showed that the operation elicited statistically significant worsening in the following symptoms: shortness of breath (SOB) rest (P = 0.018), SOB walk (P < 0.001), SOB stairs (P = 0.015), worry (P = 0.003), wound sensitivity (P < 0.001), use of arm and shoulder (P < 0.001), pain in the chest (P < 0.001), decrease in physical capability (P < 0.001) and scar interference on daily activity (P < 0.001) during the first postoperative month. SOB worsened immediately after the operation and remained low at the different time points. Worry improved following surgery. Surgical access and forced expiratory volume in 1 s (FEV1) are the factors that most strongly affected the evolution of the symptoms in the perioperative period. CONCLUSIONS We observed good early compliance of patients operated on for lung cancer with the European Society of Thoracic Surgeons QoL App. We determined the evolution of surgery-related QoL in the immediate postoperative period. Monitoring these symptoms remotely may reduce hospital appointments and help to establish early patient-support programmes.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK
| | - Jason Trevis
- Department of Thoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Miriam Patella
- Department of Thoracic Surgery, San Giovanni Hospital, Bellinzona, Switzerland
| | - Alessandro Brunelli
- Department of Thoracic Surgery, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Nuria Novoa
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Sara Tenconi
- Department of Thoracic Surgery, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - Joel Dunning
- Department of Thoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Stefano Cafarotti
- Department of Thoracic Surgery, San Giovanni Hospital, Bellinzona, Switzerland
| | - Michael Koller
- University Hospital of Regensburg, Centre for Clinical Studies Regensburg, Germany
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK
| | - Yaron Shargall
- Department of Thoracic Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
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Pompili C, Boele F, Absolom K, Holch P, Clayton B, Smyllie E, Franks K, Velikova G. Patients' views of routine quality of life assessment following a diagnosis of early-stage non-small cell lung cancer. Interact Cardiovasc Thorac Surg 2021; 31:324-330. [PMID: 32830244 DOI: 10.1093/icvts/ivaa123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/02/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES There is an increasing interest in the quality of life (QoL) evaluation following video-assisted thoracoscopic anatomical lung resection or stereotactic ablative body radiotherapy for early-stage non-small-cell lung cancer (NSCLC). A qualitative interview study was conducted to gain insight into the optimal methods of assessing and discussing QoL in clinical practice. METHODS A prospective observational longitudinal study of patients with early-stage NSCLC was conducted where repeated QoL measures were administered either online or on paper. A subset of participants was invited for qualitative interviews after the 6-month assessment or at the end of the study. The semi-structured interviews were transcribed verbatim and thematically analysed. RESULTS Twenty-three patients were interviewed. Generally, patients were content with recruitment and data collection procedures. Most opted to complete the assessments on paper instead of online; this choice was influenced by the level of technology literacy. Some found the questionnaires too generic to reflect their experiences. Barriers to questionnaire completion were mostly practical, and many acknowledged benefits of QoL assessment including allowing them to express problems and health issues, and following changes over time. Generally, participants would like to discuss QoL results during clinical consultations, but reported this rarely happened. CONCLUSIONS Lung cancer patient interviews confirm the acceptability of repeated QoL assessments, but online data capture is limited. Patients highlight the importance of discussing QoL aspects with their clinical team. Future strategies are needed to optimize the routine collection of patient-reported outcomes in clinical practice.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Florien Boele
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kate Absolom
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Patricia Holch
- School of Social Sciences, Beckett University, Leeds, UK
| | - Beverly Clayton
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Emma Smyllie
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, UK
| | - Kevin Franks
- Department of Clinical Oncology, Leeds Teaching Hospital Trust, Leeds, UK
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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7
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Whiteley J, Toolan C, Shaw M, Perin G, Palmer K, Al-Rawi O, Modi P. Patient-reported outcome measures after mitral valve repair: a comparison between minimally invasive and sternotomy. Interact Cardiovasc Thorac Surg 2021; 32:433-440. [PMID: 33831215 PMCID: PMC8906694 DOI: 10.1093/icvts/ivaa276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/15/2020] [Accepted: 10/13/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To compare patient-reported outcome measures of minimally invasive (MI) to sternotomy (ST) mitral valve repair. METHODS We included all patients undergoing isolated mitral valve surgery via either a right mini-thoracotomy (MI) or ST over a 36-month period. Patients were asked to complete a modified Composite Physical Function questionnaire. Intraoperative and postoperative outcomes, and patient-reported outcome measures were compared between 2 propensity-matched groups (n = 47/group), assessing 3 domains: 'Recovery Time', 'Postoperative Pain' (at day 2 and 1, 3, 6 and 12 weeks) and 'Treatment Satisfaction'. Composite scores for each domain were subsequently constructed and multivariable analysis was used to determine whether surgical approach was associated with domain scores. RESULTS The response rate was 79%. There was no mortality in either group. In the matched groups, operative times were longer in the MI group (P < 0.001), but postoperative outcomes were similar. Composite scores for Recovery Time [ST 51.7 (31.8-62.1) vs MI 61.7 (43.1-73.9), P = 0.03] and Pain [ST 65.7 (40.1-83.1) vs MI 79.1 (65.5-89.5), P = 0.02] significantly favoured the MI group. Scores in the Treatment Satisfaction domain were high for both surgical approaches [ST 100 (82.5-100) vs MI 100 (95.0-100), P = 0.15]. The strongest independent predictor of both faster recovery parameter estimate 12.0 [95% confidence interval (CI) 5.7-18.3, P < 0.001] and less pain parameter estimate 7.6 (95% CI 0.7-14.5, P = 0.03) was MI surgery. CONCLUSIONS MI surgery was associated with faster recovery and less pain; treatment satisfaction and safety profiles were similar.
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Affiliation(s)
- Jennifer Whiteley
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Caroline Toolan
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Matthew Shaw
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Giordano Perin
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Kenneth Palmer
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
- Department of Cardiothoracic Anaesthesia, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Omar Al-Rawi
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
- Department of Cardiothoracic Anaesthesia, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Paul Modi
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
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8
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Russell AM, Saketkoo LA. Patient-Centredness and Patient-Reported Measures (PRMs) in Palliation of Lung Disease. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Kneuertz PJ, McAlearney AS, Moffatt-Bruce SD. Patient-reported outcomes in thoracic surgery-opportunities and current challenges. J Thorac Dis 2020; 12:6880-6882. [PMID: 33282390 PMCID: PMC7711410 DOI: 10.21037/jtd.2019.12.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Peter J Kneuertz
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ann Scheck McAlearney
- Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Susan D Moffatt-Bruce
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, OH, USA
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Abstract
Radical and palliative treatments for non-small cell lung cancer (NSCLC) have faced a significant evolution during last decades, which in turn has modified their effects on the patient quality of life (QoL). QoL data collection is becoming methodologically rigorous, with published recommendations and societal statements. In lung cancer surgery, there is no standardization in collecting and analyzing this outcome yet. However, to face the evolution in lung cancer therapies, few initiatives like the European Organization for the Research and Treatment of Cancer (EORTC) lung cancer module update project or the Patient-Reported Outcomes Measurement Information System (PROMIS), have now the potential to help thoracic surgeons to collect QoL data with validated dynamic instruments to make this outcome comparable to the clinical ones. This review aims to give an overview of the available and most commonly used QoL questionnaires in lung cancer surgery in order to facilitate future research and practical implementation.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK.,Division of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Michael Koller
- Center for Clinical Studies Regensburg, University of Regensburg, Regensburg, Germany
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK
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11
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Lacroix V, Kahn D, Matte P, Pieters T, Noirhomme P, Poncelet A, Steyaert A. Robotic-Assisted Lobectomy Favors Early Lung Recovery versus Limited Thoracotomy. Thorac Cardiovasc Surg 2020; 69:557-563. [PMID: 33045756 DOI: 10.1055/s-0040-1715598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Postoperative pulmonary recovery after lobectomy has showed early benefits for the video-assisted thoracoscopic surgery and sparing open techniques over nonsparing techniques. Robotic-assisted procedures offer benefits in term of clinical outcomes, but their advantages on pulmonary recovery and quality of life have not yet been distinctly prospectively studied. METHODS Eighty-six patients undergoing lobectomy over a period of 29 months were prospectively studied for their pulmonary function recovery and pain score level during the in-hospital stay and at 1, 2, and 6 months. Quality of life was evaluated at 2 and 6 months. Forty-five patients were operated by posterolateral limited thoracotomy and 41 patients by robotic approach. The postoperative analgesia protocol differed for the two groups, being lighter for the robotic group. RESULTS The pulmonary tests were not significantly different during the in-hospital stay. At 1 month, the forced expiratory volume in 1 second, forced vital capacity, vital capacity, and maximal expiratory pressure were significantly better for the robotic group (p = 0.05, 0.04, 0.05, and 0.02, respectively). There was no significant difference left at 2 and 6 months. Pain intensity was equivalent during the in-hospital stay but was significantly lower for the robotic group at 1 month (p = 0.02). At 2 and 6 months, pain and quality of life were comparable. CONCLUSION Robotic technique can offer similar pulmonary and pain recovery during the in-hospital stay with a lighter analgesia protocol. It clearly favors the early term recovery compared with the open limited technique. The objective and subjective functional recovery becomes equivalent at 2 and 6 months.
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Affiliation(s)
- Valérie Lacroix
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - David Kahn
- Department of Anesthesiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Pascal Matte
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Thierry Pieters
- Department of Pulmonary Medicine, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Philippe Noirhomme
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Alain Poncelet
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Arnaud Steyaert
- Department of Anesthesiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.,Institute of Neuroscience, Université Catholique de Louvain, Bruxelles, Belgium
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12
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Abdur Rahman M, Rashid MM, Le Kernec J, Philippe B, Barnes SJ, Fioranelli F, Yang S, Romain O, Abbasi QH, Loukas G, Imran M. A Secure Occupational Therapy Framework for Monitoring Cancer Patients' Quality of Life. SENSORS (BASEL, SWITZERLAND) 2019; 19:E5258. [PMID: 31795384 PMCID: PMC6928807 DOI: 10.3390/s19235258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 02/02/2023]
Abstract
Once diagnosed with cancer, a patient goes through a series of diagnosis and tests, which are referred to as "after cancer treatment". Due to the nature of the treatment and side effects, maintaining quality of life (QoL) in the home environment is a challenging task. Sometimes, a cancer patient's situation changes abruptly as the functionality of certain organs deteriorates, which affects their QoL. One way of knowing the physiological functional status of a cancer patient is to design an occupational therapy. In this paper, we propose a blockchain and off-chain-based framework, which will allow multiple medical and ambient intelligent Internet of Things sensors to capture the QoL information from one's home environment and securely share it with their community of interest. Using our proposed framework, both transactional records and multimedia big data can be shared with an oncologist or palliative care unit for real-time decision support. We have also developed blockchain-based data analytics, which will allow a clinician to visualize the immutable history of the patient's data available from an in-home secure monitoring system for a better understanding of a patient's current or historical states. Finally, we will present our current implementation status, which provides significant encouragement for further development.
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Affiliation(s)
- Md. Abdur Rahman
- Department of Cyber Security and Forensic Computing, College of Computer and Cyber Sciences (C3S), University of Prince Mugrin, Madinah 41499, Saudi Arabia
| | - Md. Mamunur Rashid
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Julien Le Kernec
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
- School of Information and Communication, University of Electronic, Science, and Technology of China, Chengdu 610000, China
| | - Bruno Philippe
- Pneumology Department, René Dubos Hospital, 95300 Pontoise, France;
| | - Stuart J. Barnes
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Francesco Fioranelli
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Shufan Yang
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Olivier Romain
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
| | - Qammer H. Abbasi
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - George Loukas
- Computing and Mathematical Sciences, University of Greenwich, London SE1 09LS, UK;
| | - Muhammad Imran
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
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13
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Subramanian M, Kozower BD, Brown LM, Khullar OV, Fernandez FG. Patient-Reported Outcomes in Cardiothoracic Surgery. Ann Thorac Surg 2019; 107:294-301. [PMID: 30009806 DOI: 10.1016/j.athoracsur.2018.06.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/04/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Current studies in cardiothoracic clinical research frequently fail to use end points that are most meaningful to patients, including measures associated with quality of life. Patient-reported outcomes (PROs) represent an underused but important component of high-quality patient-centered care. Our objective was to highlight important principles of PRO measurement, describe current use in cardiothoracic operations, and discuss the potential for and challenges associated with integration of PROs into large clinical databases. METHODS We performed a literature review by using the PubMed/EMBASE databases. Clinical articles that focused on the use of PROs in cardiothoracic surgical outcomes measurement or clinical research were included in this review. RESULTS PROs measure the outcomes that matter most to patients and facilitate the delivery of patient-centered care. When effectively used, PRO measures have provided detailed and nuanced quality-of-life data for comparative effectiveness research. However, further steps are needed to better integrate PROs into routine clinical care. CONCLUSIONS Incorporation of PROs into routine clinical practice is essential for delivering high-quality patient-centered care. Future integration of PROs into prospectively collected registries and databases, including that The Society of Thoracic Surgeons National Database, has the potential to enrich comparative effectiveness research in cardiothoracic surgery.
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Affiliation(s)
- Melanie Subramanian
- Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Benjamin D Kozower
- Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Lisa M Brown
- Division of Cardiothoracic Surgery, University of California Davis Health, Davis, California
| | - Onkar V Khullar
- Section of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Felix G Fernandez
- Section of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.
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14
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Raveglia F, Scarci M, Cioffi U, Baisi A. Ultimate management of post thoracotomy morbidities: a set of surgical technique and peri-operative precautions. J Thorac Dis 2019; 11:S370-S375. [PMID: 30997224 DOI: 10.21037/jtd.2018.12.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Federico Raveglia
- Thoracic Surgery, ASST Santi Paolo e Carlo, Ospedale San Paolo, Milano, Italy
| | - Marco Scarci
- Thoracic Surgery, ASST Monza e Brianza, Ospedale San Gerardo, Monza, Italy
| | - Ugo Cioffi
- Università degli Studi di Milano, Milano, Italy
| | - Alessandro Baisi
- Thoracic Surgery, ASST Santi Paolo e Carlo, Ospedale San Paolo, Milano, Italy.,Università degli Studi di Milano, Milano, Italy
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15
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Medbery RL, Fernandez FG, Khullar OV. Patient-Reported Outcomes: Time to Integrate Into Outcomes Reporting? Semin Thorac Cardiovasc Surg 2019; 31:856-860. [DOI: 10.1053/j.semtcvs.2019.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 12/11/2022]
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16
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Pompili C, Koller M, Velikova G, Franks K, Absolom K, Callister M, Robson J, Imperatori A, Brunelli A. EORTC QLQ-C30 summary score reliably detects changes in QoL three months after anatomic lung resection for Non-Small Cell Lung Cancer (NSCLC). Lung Cancer 2018; 123:149-154. [PMID: 30089587 DOI: 10.1016/j.lungcan.2018.07.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/14/2018] [Accepted: 07/16/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION We tested the European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) summary score (SumSC) to detect changes in the HRQOL after Non-small-cell lung cancer (NSCLC) surgery and compared its performance to the traditional scales. METHOD EORTC QLQ-C30 data was obtained from 326 consecutive pre-operative patients submitted for anatomical lung resections for NSCLC.66 patients completed post-operative assessments 3 months after surgery. The data was analysed to evaluate the ability of the SumSC compared to the traditional scales to [1] preoperatively differentiate between clinical groups [2]; detect post-op changes and to [3] compare pre and post-op changes in clinically different groups.The importance of perioperative changes was measured by calculating the effect size (ES). RESULTS Of the 326 patients, those older than 70 years, with higher DLCO value and Performance Status (PS) ≤1 had a significantly better preoperative SumScore. Physical function (PF) showed a large and significant decline (ES 0.91). Role and social function also showed a significant and medium decline (ES 0.62 and 0.41). Postoperatively some symptoms scales showed significant increases in the values, implying worse symptoms with the largest increase in dyspnoea (ES -0.88). The change in General Health score (GH) was not significant after surgery (ES 0.26, p = 0.062). The SumSc, decreased significantly postoperatively. In particular, medium or large postoperative declines of SumSc were observed in both males and females, in patients with lower FEV1, lower performance score, and in those older than 70 years. Interestingly the decline of SumSc was observed irrespective of the preoperative DLCO level. DISCUSSION The Summary Score was more sensitive to changes in subjects' HRQOL, than the GH score. The SumSc can be used as a parsimonious and easy to interpreted patient-reported-outcome measure in multi-institutional database and future clinical trials.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, UK.
| | - Michael Koller
- Centre for Clinical Studies, University Hospital Regensburg, Germany
| | - Galina Velikova
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, UK
| | - Kevin Franks
- Department of Clinical Oncology, St. James's University Hospital, Leeds, UK
| | - Kate Absolom
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, UK
| | - Matthew Callister
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Jonathan Robson
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Andrea Imperatori
- Department of Thoracic Surgery St. James's University Hospital, Leeds, UK
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17
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Pompili C, Absolom K, Velikova G, Backhus L. Patients reported outcomes in thoracic surgery. J Thorac Dis 2018; 10:703-706. [PMID: 29607138 DOI: 10.21037/jtd.2018.01.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Cecilia Pompili
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Kate Absolom
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Galina Velikova
- Section of Patient Centered Outcomes Research, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Leah Backhus
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA
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18
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Pompili C, Velikova G, White J, Callister M, Robson J, Dixon S, Franks K, Brunelli A. Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer. Eur J Cardiothorac Surg 2017; 51:526-531. [PMID: 28082473 DOI: 10.1093/ejcts/ezw363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/05/2016] [Indexed: 12/20/2022] Open
Abstract
Objectives To assess whether quality of life (QOL) was associated with cardiopulmonary complications following pulmonary lobectomy for lung cancer. Methods Retrospective analysis of 200 consecutive patients who had pulmonary lobectomy for lung cancer (September 2014-October 2015). QOL was assessed by the self-administration of the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire within 2 weeks before the operation. The individual QOL scales were tested for a possible association with cardiopulmonary complications along with other objective baseline and surgical parameters by univariable and multivariable analyses. Results Forty-three patients (21.5%) developed postoperative cardiopulmonary complications; 4 of them died within 30 days (2%). Univariable analysis showed that, compared to patients without complications, those with complications reported a lower global health status (GHS) [59.1; standard deviation (SD) 27.2 vs 69.6; SD 20.6, P = 0.02], were older (71.2; SD 8.4 vs 67.7; SD 9.4, P = 0.03), had lower values of forced expiratory volume in one second (FEV1) (83.9; SD 27.2 vs 91.4; SD 20.9), P = 0.06) and carbon monoxide lung diffusion capacity (DLCO) (67.9; SD 20.9 vs 74.2; SD 17.6, P = 0.02) and higher performance score (0.76; SD 0.63 vs 0.53; SD 0.64, P = 0.02). Stepwise logistic regression analysis showed that factors independently associated with cardiopulmonary complications were age [odds ratio (OR) 1.04, 95% CI 1.0-1.09, P = 0.02] and patient-reported GHS [OR 0.98, 95% confidence interval (CI) 0.96-0.99, P = 0.006], whereas other objective parameters (i.e. FEV1, DLCO) were not. The best cut-off value for GHS to discriminate patients with complications after surgery was 50 (c-index 0.65, 95% CI 0.58-0.72). Conclusions A poor GHS perceived by the patient was associated with postoperative cardiopulmonary morbidity. Patient perceptions and values should be included in the risk stratification process to tailor cancer treatment.
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Affiliation(s)
- Cecilia Pompili
- Leeds Institute of Cancer and Pathology, Section of Patient Centered Outcomes Research, Leeds, UK
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, Section of Patient Centered Outcomes Research, Leeds, UK
| | - John White
- Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Matthew Callister
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Jonathan Robson
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Sandra Dixon
- Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Kevin Franks
- Department of Clinical Oncology, St. James's University Hospital, Leeds, UK
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Scarci M, Caruana E, Bertolaccini L, Bedetti B, Brunelli A, Varela G, Papagiannopoulos K, Kuzdzal J, Massard G, Ruffini E, Falcoz PE, Opitz I, Batirel H, Toker A, Rocco G. Current practices in the management of malignant pleural effusions: a survey among members of the European Society of Thoracic Surgeons. Interact Cardiovasc Thorac Surg 2017; 24:414-417. [PMID: 28040756 DOI: 10.1093/icvts/ivw373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/27/2016] [Indexed: 01/27/2023] Open
Abstract
Objectives Malignant pleural effusion (MPE) commonly complicates advanced malignancy and their exact management is still undefined. We undertook a survey to determine the current practice among members of the European Society of Thoracic Surgeons (ESTS). Methods A cross-sectional survey focused on the current practice of management of MPE was developed by the authors. The questions were outlined after a review of the literature and circulated in an Internet-based survey format. Results Computed tomography (125, 92%) and chest X-ray (106, 78%) are the most common imaging modalities performed in the initial evaluation. Video-assisted thoracoscopic surgery for washout and pleurodesis (93, 68%) was reported as the preferred approach to patients with uncomplicated MPE. Sixty-one (45%) of the responding colleagues routinely use large bore chest tubes for draining malignant effusions. Forty-nine (35%) surgeons would not apply suction to the drainage system, whilst 50 (37%) would use -2 kPa or less. Talc (124, 91%) is the most commonly used sclerosing agent for pleurodesis in the context of malignant pleural effusion. The practice of 76 (56%) of the respondents is not informed by any clinical guidelines, whilst 60 (44%) reported adhering to the 2010 British Thoracic Society Pleural Disease Guideline. Seventy-one (52%) declared that the guidance was in need of updating or revision. Conclusions This survey demonstrates the lacking adoption of the existing clinical guidance in this field, as well as the need for more contemporary guidelines for a better-informed practice. The ESTS Working Group on the management of MPE has been established for this purpose.
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Affiliation(s)
- Marco Scarci
- Department of Thoracic Surgery, University College London Hospitals, London, United Kingdom
| | - Edward Caruana
- Department of Thoracic Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Luca Bertolaccini
- Department of Thoracic Surgery, Sacro Cuore, Don Calabria Research Hospital, Negrar, Verona, Italy
| | - Benedetta Bedetti
- Department of Thoracic Surgery, University College London Hospitals, London, United Kingdom
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom
| | - Gonzalo Varela
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | | | - Jaroslaw Kuzdzal
- Department of Thoracic Surgery, Jagiellonian University Collegium Medicum, John Paul II Hospital, Cracow, Poland
| | - Gilbert Massard
- Department of Thoracic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - Enrico Ruffini
- Department of Thoracic Surgery, University of Torino, Torino, Italy
| | | | - Isabelle Opitz
- Division of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Alper Toker
- Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Gaetano Rocco
- Division of Thoracic Surgery, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori, Fondazione Pascale, IRCSS, Naples, Italy
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Al-Ameri M, Bergman P, Franco-Cereceda A, Sartipy U. Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival. Ann Thorac Surg 2017; 103:484-490. [DOI: 10.1016/j.athoracsur.2016.06.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/15/2016] [Accepted: 06/20/2016] [Indexed: 11/16/2022]
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21
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Van Schil PE. eComment. Quality of life in thoracic surgery: often neglected but of vital importance! Interact Cardiovasc Thorac Surg 2015; 21:419. [PMID: 26392578 DOI: 10.1093/icvts/ivv220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Paul E Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium
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