Impact on quality of life after vagus nerve and phrenic nerve guided systematic nodal dissection for non-small cell lung cancer patients: a prospective, single-arm clinical trial

BACKGROUND: Patients with non-small cell lung cancer (NSCLC) suffer a decrease in quality of life (QOL) after receiving curative lobectomy and mediastinal lymph node dissection via video-assisted thoracoscopic surgery (VATS). We aimed to explore the preliminary influence of our modified approach called the duo-nerve-guided systematic nodal dissection (SND) on patients’ QOL. METHODS: Between October 2018 and March 2019, 21 patients were enrolled from the First Affiliated Hospital of Sun Yat-sen University and received curative lobectomy and duo-nerve-guided SND for clinical stage I to IIIA NSCLC. Participants’ QOL was evaluated by Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire before operation and at 1- and 3-month postoperatively. RESULTS: The overall QOL scores at 1 month after surgery were significantly lower than those before surgery (116.13 vs. 126.63, P=0.001), while there was no significant difference in the overall QOL score between preoperative and 3 months after surgery. In particular, among the 5 subscales, physical well-being (PWB), functional well-being (FWB), and trial outcome index (TOI) significantly declined at 1 month after surgery. However, each subscale showed significant improvement at 3 months after operation compared with that at 1 month and basically returned to the level at baseline. In addition, there was a significant improvement in the emotional well-being (EWB) domain 3 months after surgery (23.00 vs. 18.00, P=0.001). CONCLUSIONS: As evidenced by patients’ QOL at 3 months after receiving duo-nerve-guided SND being not significantly different from that at baseline, the improved SND procedure has positive effects on the fast recovery of NSCLC patients.