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Lung cancer-specific symptoms and fear of cancer recurrence among recurrence-free non-small cell lung cancer survivors

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Abstract

Purpose

Lung cancer survivors have more psychosocial problems, including depression and anxiety disorder, than other cancer survivors. Lung cancer-specific symptoms, such as cough, dyspnea, or pain in chest, might increase FCR among survivors. We aimed to evaluate the association between lung cancer-specific symptoms and FCR among recurrence-free non-small cell lung cancer (NSCLC) survivors.

Methods

This is a cross-sectional study. Recurrence-free NSCLC survivors were recruited from January to October 2020 at a tertiary hospital in Seoul, Korea. We measured FCR using the Korean version of FCRI-SF and categorized them into three groups: non-clinical FCR (nFCR, < 13), subclinical FCR (sFCR, 13 to 21), and clinical FCR (cFCR, ≥ 22). Lung cancer-specific symptoms were measured using the Korean version of EORTC QLQ-LC13 and EORTC QLQ-C30.

Results

A total of 727 survivors were enrolled. One-third (30.8%) of survivors reported sFCR, and 19.7% had cFCR. In a multivariate analysis, survivors with severe pain in chest were 4.7 times (95% CI: 2.4–9.0) more likely to experience cFCR compared to those without it. Mild dyspnea (OR 1.7, 95% CI: 1.1–2.7) and mild dysphagia (OR 2.4, 95% CI: 1.3–4.4) were associated with cFCR. Survivors with sFCR (Coef. − 6.3, 95% CI: − 9.8, − 2.8) and cFCR (Coef. − 11.3, 95% CI: − 15.5, − 7.2) had poorer quality of life compared to survivors with nFCR.

Conclusion

NSCLC survivors were experiencing lung cancer-specific symptoms even a few years after treatment, which were associated with cFCR, resulting in poor HRQoL. It is necessary to develop a lung cancer-specific symptom checklist and use it during even long-term surveillance.

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Data availability

Data is available on request from the corresponding author.

Abbreviations

FCR:

Fear of cancer recurrence

QoL:

Quality of life

HRQoL:

Health-related quality of life

NSCLC:

Non-small cell lung cancer

K-FCRI-SF:

Korean version of the Fear of Cancer Recurrence Inventory-Short Form

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2020R1F1A1075388).

Author information

Authors and Affiliations

  1. Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, 06351, South Korea

    Genehee Lee, Dongok Lee, Tae Eun Kim, Sunga Kong, Danbee Kang, Hong Kwan Kim, Young Mog Shim & Juhee Cho

  2. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, South Korea

    Genehee Lee, Sunga Kong, Danbee Kang & Juhee Cho

  3. Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, 77341, USA

    Alice Ahn

  4. Center for Clinical Epidemiology, Samsung Medical Center, Seoul, 06351, South Korea

    Danbee Kang & Juhee Cho

  5. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea

    Hong Kwan Kim & Young Mog Shim

  6. Departments of Health, Behavior, and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA

    Juhee Cho

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  1. Genehee Lee
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Contributions

All authors contributed to the conception and design of the study. G.L., A.A., D.L., T.E.K., and S.K. collected and prepared the data. G.L. and J.C. analyzed the data and wrote the main manuscript. D.K., H.K.K., and Y.M.S edited the manuscript and performed validation and visualization of the data. J.C. supervised the entire process. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Juhee Cho.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the Institutional Review Board (IRB) of the Samsung Medical Center (IRB number: SMC 2018–09-037).

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Informed consent was obtained from all individual participants included in the study.

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Patients provided informed consent for publication.

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The authors declare no competing interests.

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Genehee Lee is the first author.

Supplementary Information

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Supplementary Figure 1

FCR score according to the postoperative period (PNG 26.1 kb)

Supplementary file1 (TIF 410 KB)

Supplementary Figure 2

Prevalence of mild or severe symptoms according to the postoperative period. (PNG 275 kb)

Supplementary file2 (TIF 3075 KB)

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Lee, G., Ahn, A., Lee, D. et al. Lung cancer-specific symptoms and fear of cancer recurrence among recurrence-free non-small cell lung cancer survivors. Support Care Cancer 32, 322 (2024). https://doi.org/10.1007/s00520-024-08505-3

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