Yonsei Med J.  2016 Sep;57(5):1063-1069. 10.3349/ymj.2016.57.5.1063.

Dyspnea as a Prognostic Factor in Patients with Non-Small Cell Lung Cancer

• Ban W
• Lee JM
• Ha JH
• Yeo CD
• Kang HH
• Rhee CK
• Moon HS
• Lee SH

• KMID: 2374149
• DOI: http://doi.org/10.3349/ymj.2016.57.5.1063

Abstract

PURPOSE
To investigate associations between dyspnea and clinical outcomes in patients with non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
From 2001 to 2014, we retrospectively reviewed the prospective lung cancer database of St. Paul's Hospital at the Catholic University of Korea. We enrolled patients with NSCLC and evaluated symptoms of dyspnea using modified Medical Research Council (mMRC) scores. Also, we estimated pulmonary functions and analyzed survival data.
RESULTS
In total, 457 NSCLC patients were enrolled, and 259 (56.7%) had dyspnea. Among those with dyspnea and whose mMRC scores were available (109 patients had no mMRC score), 85 (56.6%) patients had an mMRC score <2, while 65 (43.3%) had an mMRC score ≥2. Significant decreased pulmonary functions were observed in patients with dyspnea. In multivariate analysis, aging, poor performance status, advanced stage, low forced expiratory volume in 1 second (%), and an mMRC score ≥2 were found to be significant prognostic factors for patient survival.
CONCLUSION
Dyspnea could be a significant prognostic factor in patients with NSCLC.

Keyword

Lung neoplasm; dyspnea; prognosis

MeSH Terms

Aged
Carcinoma, Non-Small-Cell Lung/complications/pathology/*physiopathology
Dyspnea/*etiology/*physiopathology
Female
Forced Expiratory Volume
Humans
Lung Neoplasms/complications/pathology/*physiopathology
Male
Neoplasm Staging
Prognosis
Retrospective Studies
Severity of Illness Index

Figure

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  Fig. 1 Distribution of patients with dyspnea according to modified Medical Research Council (mMRC) scale.

• 

  Fig. 2 Prevalence of chronic obstructive pulmonary disease in patients with dyspnea. FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease.

• 

  Fig. 3 Kaplan-Meier survival curve of patients according to dyspnea (A) and modified Medical Research Council (mMRC) scale (B).

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