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

Yaqian Feng; Wei Dai; Yaqin Wang; Jia Liao; Xing Wei; Shaohua Xie; Wei Xu; Qiang Li; Fang Liu; Qiuling Shi

doi:10.2147/PPA.S307814

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

Patient Prefer Adherence. 2021 May 25:15:1101-1106. doi: 10.2147/PPA.S307814. eCollection 2021.

Authors

Yaqian Feng¹, Wei Dai¹, Yaqin Wang¹, Jia Liao¹, Xing Wei¹, Shaohua Xie¹, Wei Xu², Qiang Li¹, Fang Liu³, Qiuling Shi⁴

Affiliations

¹ Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China.
² School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China.
³ Traditional Chinese Medicine Department of Oncology, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China.
⁴ Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China.

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: chief complaint; lung cancer; patient-reported outcomes; surgery; symptom.

Grants and 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).