Mapping symptom networks at time of presentation with metastatic lung cancer: Age-related differences and insights from cluster analysis.

INTRODUCTION

Patients with metastatic lung cancer often experience significant symptom burden. This study aimed to describe baseline symptoms in adults with metastatic lung cancer at diagnosis, identify age-related differences, and examine symptom clusters and intercorrelations.

MATERIALS AND

METHODS

This retrospective study analyzed Edmonton Symptom Assessment System scores from patients with newly diagnosed stage IV lung cancer (2015-2016). Patients were stratified by age (<65 vs ≥65 years). Descriptive statistics, generalized linear regression analysis, principal component analysis, and network analysis were used to examine symptom profiles and clustering.

RESULTS

Of the 359 included patients, 213 (58.3%) were ≥ 65 years old. Median (interquartiles) total symptom distress score was 22 (11, 39). Two main symptom clusters emerged: physical (pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath) and psychological (depression, anxiety, wellbeing). No significant differences in overall symptom burden were found between age groups, except older patients reported worse lack of appetite (p = 0.04). Network analysis identified wellbeing, tiredness, and depression as central, highly interconnected symptoms across age groups.

DISCUSSION: Older and younger patients with metastatic lung cancer experience a similar high symptom burden at diagnosis. Routine comprehensive symptom assessment is important for all age groups. The identified symptom clusters and central symptoms may help guide targeted supportive care interventions to improve quality of life in this population.