The effect of lobar versus sublobar video-assisted thoracoscopic surgery lung resection on patient quality of life
Bibliographic record
Abstract
Background: The debate regarding the optimal extent of resection for early-stage lung cancer continues despite 2 major phase 3 trials, yet data regarding patient quality of life (QoL) comparing lobar and sublobar resections is lacking. This study aimed to characterize changes to QoL in the short-term postoperative timeline. Methods: A single center retrospective study reviewed patients from 2017–2021 who underwent video-assisted thoracoscopic surgery (VATS) lobectomy, segmentectomy, and wedge resection for primary lung cancer. QoL was assessed using the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy-Lung (FACT-L). Univariate and regression analyses were performed to assess approaches. Results: Altogether, 134 patients met the inclusion criteria: lobectomies 65% (87/134), segmentectomies 17% (23/134), and wedge resections 18% (24/134). Stage I disease represented 73% (98/134), stage II 19% (26/134), and stage III 8% (10/134). Patients undergoing wedge resections did not experience a significant change in pre- versus postoperative FACT-L, and in fact experienced a decrease in anxiety (pre-op: 2.42±3.06 vs. post-op: 1.33±2.20; P=0.02). Similarly, patients undergoing segmentectomy had no change in FACT-L scores, yet they experienced an increase in the ESAS domains of pain (pre-op: 0.87±1.33 vs. post-op: 3.17±2.35; P<0.001), fatigue (pre-op: 2.30±2.23 vs. post-op: 4.17±2.37; P=0.01) and shortness of breath (pre-op: 2.26±2.54 vs. post-op: 3.91±2.97; P=0.01). Patients who underwent lobectomy experienced a decrease in QoL based on FACT-L (pre-op: 104.90±17.52 vs. post-op: 93.77±19.04; P<0.001), driven largely by changes in the domains for pain (pre-op: 1.54±2.31 vs. post-op: 3.13±2.16; P<0.001), fatigue (pre-op: 2.67±3.00 vs. post-op: 3.76±2.75; P=0.01), appetite (pre-op: 2.49±3.35 vs. post-op: 3.55±3.34; P=0.045), depression (pre-op: 0.59±1.87 vs. post-op: 1.08±2.08; P=0.03) and shortness of breath (pre-op: 2.05±2.74 vs. post-op: 3.90±2.75; P<0.001). These findings were unrelated to length of stay, operative time and surgical complications. Conclusions: Amongst patients undergoing minimal access pulmonary surgery, the extent of pulmonary resection may influence early postoperative QoL. These non-randomized data are hypothesis generating and suggest that patients undergoing sublobar resections may experience a faster return to baseline QoL as compared to those who undergo lobectomy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".