General Thoracic and Cardiovascular Surgery

, Volume 67, Issue 12, pp 1056–1061 | Cite as

Quality assessment using EQ-5D-5L after lung surgery for non-small cell lung cancer (NSCLC) patients

  • Ryo Koide
  • Ami Kikuchi
  • Masahiro Miyajima
  • Taijiro Mishina
  • Yuki Takahashi
  • Miho Okawa
  • Izumi Sawada
  • Junko Nakajima
  • Atsushi Watanabe
  • Toru MizuguchiEmail author
Original Article



Aim of this study was to elucidate an alteration of quality of life (QOL) score before and after video-assisted thoracoscopic surgery (VATS) for non-small cell lung cancer (NSCLC) patients using the 5-level EuroQol-5D questionnaire (EQ-5D-5L). We also investigated how the preoperative QOL scores affected the postoperative clinical outcome prospectively.


Between July 2018 and December 2018, 24 consecutive NSCLC patients who underwent VATS were recruited. The EQ-5D-5L for Japanese was used with face-to-face interviews to estimate the utility values of QOL.


QOL scores were significantly declined after surgery (0.81 ± 0.19 vs. 0.74 ± 0.11: P = 0.049). The levels of EQ-5D-5L questionnaire were not significantly different before and after surgery except Q4 (pain control). The levels of Q4 were significantly worsened after surgery (1.33 ± 0.56 vs. 1.88 ± 0.61, P < 0.001). Operation time and bleeding in the preoperative low-QOL score group (N = 13) was longer (215.4 ± 52.3 min. vs. 173.5 ± 42.3 min., respectively: P = 0.045) and more (116.2 ± 152.7 ml vs. 22.7 ± 20.1 ml, respectively: P = 0.049) than those in the high-QOL score group (N = 11).


QOL survey for lung cancer patients using EQ-5D-5L is simple and useful to identify the issue facing at the medical team. Preoperative low QOL score could be a predicting factor for the longer operation time and more bleeding.


Lung surgery EuroQol Pain Quality of life VATS 



Supported by Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan, no. 17K10672 to T. Mizuguchi. Part of the study was also supported by Astellas Pharma Inc. (Tokyo, Japan), Daiichi Sankyo Company (Tokyo, Japan), Shionogi & Co. (Osaka, Japan), Sapporo Doto Hospital (Sapporo, Japan), Noguchi Hospital (Otaru, Japan), Doki-kai Tomakomai Hospital (Tomakomai, Japan), Tsuchida Hospital (Sapporo, Japan) and Ikuta Hospital (Shiraoi, Japan).

Compliance with ethical standards

Conflict of interest

Ryo Koide and other co-authors have no conflict of interest.


  1. 1.
    McCoy CE. Understanding the use of composite endpoints in clinical trials. West J Emerg Med. 2018;19:631–4.CrossRefGoogle Scholar
  2. 2.
    Urbach DR, Harnish JL, McIlroy JH, Streiner DL. A measure of quality of life after abdominal surgery. Qual Life Res. 2006;15:1053–61.CrossRefGoogle Scholar
  3. 3.
    Arai H, Ouchi Y, Yokode M, Ito H, Uematsu H, Eto F, et al. Toward the realization of a better aged society: messages from gerontology and geriatrics. Geriatr Gerontol Int. 2012;12:16–22.CrossRefGoogle Scholar
  4. 4.
    Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A. Quality of life of patients with lung cancer. OncoTargets Ther. 2016;9:1023–8.Google Scholar
  5. 5.
    Shiroiwa T, Fukuda T, Ikeda S, Igarashi A, Noto S, Saito S, et al. Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D. Qual Life Res. 2016;25:707–19.CrossRefGoogle Scholar
  6. 6.
    Hopkins KG, Ferson PF, Shende MR, Christie NA, Schuchert MJ, Pennathur A. Prospective study of quality of life after lung cancer resection. Ann Transl Med. 2017;5:204.CrossRefGoogle Scholar
  7. 7.
    Ebrahim S. Clinical and public health perspectives and applications of health-related quality of life measurement. Soc Sci Med. 1995;41:1383–94.CrossRefGoogle Scholar
  8. 8.
    Brooks R. EuroQol: the current state of play. Health Policy. 1996;37:53–72.CrossRefGoogle Scholar
  9. 9.
    Neto AS, Hemmes SN, Barbas CS, Beiderlinden M, Fernandez-Bustamante A, Futier E, et al. Incidence of mortality and morbidity related to postoperative lung injury in patients who have undergone abdominal or thoracic surgery: a systematic review and meta-analysis. Lancet Respir Med. 2014;2:1007–15.CrossRefGoogle Scholar
  10. 10.
    Riquet M, Mordant P, Pricopi C, Legras A, Foucault C, Dujon A, et al. A review of 250 ten-year survivors after pneumonectomy for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45:876–81.CrossRefGoogle Scholar
  11. 11.
    Whitehead SJ, Ali S. Health outcomes in economic evaluation: the QALY and utilities. Br Med Bull. 2010;96:5–21.CrossRefGoogle Scholar
  12. 12.
    Pompili C. Quality of life after lung resection for lung cancer. J Thorac Dis. 2015;7:S138–44.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Brunelli A, Salati M, Refai M, Xiume F, Berardi R, Mazzanti P, et al. Development of a patient-centered aggregate score to predict survival after lung resection for non-small cell lung cancer. J Thorac Cardiovasc Surg. 2013;146(385–90):e1–2.Google Scholar
  14. 14.
    Pompili C, Velikova G, White J, Callister M, Robson J, Dixon S, et al. Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer. Eur J Cardiothorac Surg. 2017;51:526–31.PubMedGoogle Scholar
  15. 15.
    Fernando HC, Landreneau RJ, Mandrekar SJ, Nichols FC, DiPetrillo TA, Meyers BF, et al. Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer: results from the ACOSOG Z4032 (Alliance) multicenter randomized trial. J Thorac Cardiovasc Surg. 2015;149:718–25.CrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Department of Nursing ISapporo Medical University Postgraduate School of Health ScienceSapporoJapan
  2. 2.Department of Nursing, Division of Surgical ScienceSapporo Medical University Postgraduate School of Health ScienceSapporoJapan
  3. 3.Department of Thoracic SurgerySapporo Medical University Postgraduate School of MedicineSapporoJapan

Personalised recommendations