Objective To evaluate the effect of chest wall resection on pulmonary function and quality of life in patients with non-small cell lung cancer (NSCLC). Methods A total of 998 patients with NSCLC who underwent lung resection in our hospital were included. The patients were divided into chest wall resection group (study group) and non-chest wall resection group (control group) according to whether the patient underwent chest wall resection. Using the 1:1 nearest neighbor matching method,two groups of patients were used to obtain a balanced sample. The cumulative mortality,the incidence of complications, and the length of hospitalization were compared between the two groups. The changes of pulmonary function test (PFT) in the baseline and postoperative 6 and 12 months were evaluated. At the same time, the changes of lung cancer symptom scale (LCSS) score at baseline and postoperative 1,6 months were compared between the two groups. Results A total of 106 pairs of patients matched successfully. There was no significant difference in the mortality rate(P=0.317) and the complication rate (all P>0.05) between the study group and the control group. The length of stay in the study group was significantly longer than that in the control group[(12.86 ± 3.17) d vs. (8.92 ± 2.56) d,t=9.956,P<0.01]. The PFT values of the 6th and 12th month in the two groups were significantly lower than those of the baseline (P<0.05). The values of FVC and FVC% in the study group were significantly higher than those in the control group(t=13.580,t=15.069,P<0.01). There was no statistical-ly significant difference in the LCSS between the study group and the control group (P>0.05) at baseline and 1 month and 6 months after treatment. Conclusion When the patient with NSCLC tumor tissue invading the chest wall has to undergo a resec-tion of the chest wall,pneumonectomy with resection of the chest wall does not worsen the patient's postoperative quality of life and lung function.%目的 评价胸壁切除术对非小细胞肺癌(NSCLC)患者肺功能与生活质量的影响.方法 选取2008年1月—2016年12月在自贡市第四人民医院胸心外科行肺切除手术的NSCLC患者998例,根据患者是否行胸壁切除术将患者分为胸壁切除术组(研究组)106例,非肺壁切除术组(对照组)892例.运用倾向性评分匹配,对2组患者应用1:1最邻近匹配法,得到组间变量均衡的样本,2组最终纳入各106例.比较2组患者的累计病死率、并发症发病率与住院时间,评价2组患者基线期、术后6、12个月常规肺功能检查(PFT)指标的变化,同时比较2组患者基线期、术后1、6个月肺癌症状量表(LCSS)评分的变化.结果 在围术期,研究组与对照组患者病死率、并发症发生率比较差异无统计学意义(P均>0.05).研究组住院时间显著长于对照组[(12.86 ± 3.17)d vs. (8.92 ± 2.56)d,t=9.956, P<0.01].2组患者第6、12个月常规肺功能(PFT)值均较基线期显著降低(P均<0.05),同时研究组患者FVC、FVC%值显著高于对照组(t=13.580、15.069,P<0.01).研究组与对照组的食欲、疲劳、咳嗽、气促与疼痛评分在术后1个月均较基线值显著提高,差异有统计学意义(P均<0.05);在基线期、治疗后1个月与6个月,研究组与对照组LCSS评分比较,差异无统计学意义( P>0.05).结论 当肿瘤组织侵犯胸壁的NSCLC患者必需进行胸壁切除术时,胸壁切除术不会使患者的术后生活质量和肺功能恶化.
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