Comparison of Chief Complaints and Patient-Reported Symptoms of Treatment-Naive Lung Cancer Patients Before Surgery

Abstract

Background

Lung cancer patients without chief complaints have been increasingly identified by physical examination. This study aimed to profile and compare chief complaints with patient-reported symptoms of lung cancer patients before surgery.

Methods

Data were extracted from a multicenter, prospective longitudinal study (CN-PRO-Lung 1) in China from November 2017 to January 2020. A comparison between chief complaints and patient-reported symptoms was analyzed using the Chi-squared test.

Results

A total of 201 (50.8%) lung cancer patients without chief complaints were found by physical examination at admission, and 195 (49.2%) patients had chief complaints. The top 5 chief complaints were coughing (38.1%), expectoration (25.5%), chest pain (13.6%), hemoptysis (10.6%), and shortness of breath (5.3%). There were significantly more patients with chief complaints of coughing (38.1% vs 15.0%, P <0.001) and pain (20.5% vs 6.9%, P<0.001) than those with the same symptoms rated ≥4 via MD Anderson Symptom Inventory‒Lung Cancer (MDASI-LC). There were less patients with chief complaints of fatigue (1.8% vs 10.9%, P<0.001), nausea (0.3% vs 2.5%, P=0.006), and vomiting (0.3% vs 1.8%, p=0.032) than those with the same symptoms rated ≥4 via MDASI-LC. In patients without chief complaints, the five most common moderate to severe patient-reported symptoms were disturbed sleep (19.5%), distress (13.5%), dry mouth (13%), sadness (12%), and difficulty remembering (11.1%).

Conclusion

Symptoms of lung cancer patients not included in the chief complaint could be identified via a patient-reported outcome instrument, suggesting the necessity of implementing the patient-reported outcome assessment before lung cancer surgery for better patient care.

Keywords:

• lung cancer
• chief complaint
• surgery
• symptom
• patient-reported outcomes

Abbreviations

CT, computerized tomography; BMI, body mass index; PRO, patient-reported outcome; MDASI-LC, MD Anderson Symptom Inventory Lung Cancer Module; RED Cap, Research Electronic Data Capture.

Ethics Approval and Consent to Participate

The study protocol was approved by the Ethics Committee of Sichuan Cancer Hospital (approved number: SCCHEC-02-2017-042).

I confirm that all experiments were performed in accordance with relevant guidelines and regulations, and confirm that informed consent was obtained from all subjects. This study was conducted in accordance with the Declaration of Helsinki. We are willing to share data related to this article with other researchers. Other researchers can contact the corresponding author by email. We will provide relevant data for this study.

Acknowledgments

We thank the patients for their cooperation and time. The abstract was selected for presentation as poster in 23rd Chinese Society of Clinical Oncology.

Disclosure

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Additional information

Funding

This work was supported by grants from the Sichuan Science and Technology Program (No. 2019YFH0070) and National Natural Science Foundation of China (No. 81872506).