Impact of peripheral muscle strength and functional exercise capacity on health-related quality of life after surgical treatment in patients with non-small-cell lung cancer

Abstract

Background: There are several factors associated with the worsening of health-related quality of life (QOL) in patients with after resection of non-small cell lung cancer (NSCLC). However, how the physical function in postoperative period affects the QOL are unknown.

Methods: Forty-four patients with NSCLC who underwent surgical resection were enrolled. Skeletal muscle force (handgrip and quadriceps force; HF, QF) and 6-min walk distance (6MWD) were measured before and 1 week after resection, and QOL was prospectively assessed preoperatively and 1, and 3 months after surgery using the EORTC QLQ C-30 questionnaire. The patients were divided into two groups according to the decrease of minimum important difference in domain of physical function (PF): group 1 < 5 and group 2 ≥ 5 points, and differences between groups were evaluated.

Results: The PF was deteriorated in 36 patients (82%) at 1 month, and 22 (50%) at 3 months. Differences between before and after surgery were 1.1±2.9kg vs. 2.1±2.5kg (p=.37) in HF, 4.3±10.8kgf vs. 0.8±8.2kgf (p=.75) in QF, and 56.4±53.9m vs. 40.6±43.0m (p=.44) in 6MWD at 1 month after surgery, and 1.0±2.3kg vs. 1.6±3.3kg (p=.43) in HF, 2.6±10.2kgf vs. 2.3±7.2kgf (p=.60) in QF, and 69.6±48.6m vs. 37.5±55.1m (p<.05) in 6MWD at 3 months after in group 1 and 2, respectively.

Conclusions: A decrease in functional exercise capacity after resection significantly affected QOL in patients who underwent surgical resection. These results suggest that exercise training in earlier postoperative period should be applied to improve QOL.