Sex-related differences in postoperative patient-reported outcomes among lung cancer patients: a multicenter cohort study
Jia Liao,
Xiaoqun Hu,
Xing Wei,
Wei Dai,
Hongfan Yu,
Xin Tian,
Yaqin Wang,
Qin Qin,
Na Xu,
Yuanyuan Li,
Qiang Li,
Qiuling Shi,
Xiaoqin Liu
Affiliations
Jia Liao
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Xiaoqun Hu
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Xing Wei
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Wei Dai
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Hongfan Yu
State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University
Xin Tian
School of Public Health, Chongqing Medical University
Yaqin Wang
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Qin Qin
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Na Xu
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Yuanyuan Li
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Qiang Li
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Qiuling Shi
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Xiaoqin Liu
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China
Abstract Background Studies on sex-related differences in post-lung cancer surgery symptoms are limited. Understanding these differences may provide insights into patient recovery. Therefore, we investigated sex-related differences in these symptoms and their underlying associated factors. Methods We included patients aged ≥ 18 years undergoing surgery for lung cancer from a multicenter cohort study (CN-PRO-Lung 1) that focused on postoperative lung cancer symptoms trajectories. On a daily assessment schedule, we evaluated patients’ symptoms and their impact on functioning from the day before surgery until discharge using the MD Anderson Symptom Inventory–Lung Cancer module. We evaluated sex-related differences in symptom scores over time and identified influencing factors using linear mixed models. Results Of 372 eligible patients (196 men and 176 women;) symptoms were milder in men than in women for pain (estimate = 0.427, P = 0.021), fatigue (estimate = 1.071, P < 0.001), shortness of breath (estimate = 0.431, P = 0.021), lack of appetite (estimate = 0.728, P < 0.001), dry mouth (estimate = 0.438, P = 0.015), and constipation (estimate = 0.887, P < 0.001) during postoperative hospitalization (median: 7 days). Pain scores decreased over time in both sexes (estimate = -0.440 in men, P < 0.001; -0.510 in women, P < 0.001), while different factors were associated with increased pain in each group. In men, higher American Society of Anesthesiologists (ASA) classification (estimate = 0.430, P = 0.035), advanced pTNM stage (estimate = 0.550, P = 0.007), and having more than one chest drain (estimate = 0.690, P = 0.001) were associated with greater pain. In women, systematic lymph node dissection was associated with increased pain (estimate = 0.700, P = 0.033). Conclusions Women reported a higher symptom burden than men in the early postoperative period after lung cancer surgery. Key factors associated with worse postoperative pain include higher ASA classification, advanced pTNM stage, and more than one chest tube in men and systematic lymph node dissection in women. Trial registration number NCT03341377
