The effect of smoking cessation on quality of life after lung cancer surgery.

OBJECTIVE

This study aimed to evaluate the effect of smoking status on quality of life (QoL) after non-small-cell lung cancer surgery with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC13.

METHODS

QoL was prospectively recorded in 70 consecutive patients undergoing lobectomy or pneumonectomy. Questionnaires were administered preoperatively and 1, 3, 6 and 12 months postoperatively (MPO).

RESULTS

Of all patients analysed, nine (13%) were non-smokers, 20 (29%) former smokers, six (8%) recent quitters and 35 (50%) current smokers. All four groups had comparable patients' characteristics and preoperative QoL scores, with exception of non-smokers who had significantly lower physical functioning, role functioning, cognitive functioning and a higher thoracic pain burden. In non-smokers, all QoL scores returned to baseline 3 months after surgery. Former smokers complained of a significant 3-month decrease in physical functioning (3 MPO, p = 0.01) and a 12-month decrease in role functioning (12 MPO, p = 0.01). Former smokers complained of a significant increase in dyspnoea (6 MPO, p = 0.001) during the first 6 months after surgery. Recent quitters had a longer impairment in physical functioning (6 MPO, p = 0.01) and a 3-month burden of dyspnoea (3 MPO, p=0.02). In current smokers, no return to baseline in physical (12 MPO, p = 0.01), role (12 MPO, p = 0.01) and social functioning (12 MPO, p = 0.02) and a persistent increase in dyspnoea (12 MPO, p = 0.04) were reported. Current smokers also complained of increased thoracic pain (12 MPO, p = 0.02). Except non-smokers, all patients complained of fatigue the first 3 months after surgery.

CONCLUSIONS

Smoking cessation is beneficial at any time point to lung cancer surgery and current smoking at the time of surgery is associated with a poor postoperative QoL.