open access

Vol 89, No 3 (2021)
Research paper
Published online: 2021-06-30
Submitted: 2020-10-07
Accepted: 2021-03-07
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Effectiveness of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease after lobectomy due to non-small cell lung cancer — a single-center retrospective study

Magdalena Klimczak1, Damian Piekielny2, Adam Antczak2, Jacek Śmigielski3, Damian Tworek2
DOI: 10.5603/ARM.a2021.0060
·
Pubmed: 34196376
·
Adv Respir Med 2021;89(3):247-253.
Affiliations
  1. Lung Diseases Treatment and Rehabilitation Centre in Lodz, Łódź, Poland
  2. Department of General and Oncological Pulmonology, Medical University of Lodz, Łódź, Poland
  3. Department of Thoracic, Oncological and General Surgery, 4th Military Hospital, Wrocław, Łódź, Poland

open access

Vol 89, No 3 (2021)
ORIGINAL PAPERS
Published online: 2021-06-30
Submitted: 2020-10-07
Accepted: 2021-03-07

Abstract

Introduction: The procedure of lung parenchyma resection may result in impairment of physical capacity and quality of life. In patients with operable non-small cell lung cancer (NSCLC), lobectomy is an elective procedure. Chronic obstructive pulmonary disease (COPD) is a common coexisting condition in patients with NSCLC. Effectiveness of post-operative pulmonary rehabilitation (PR) in patients who underwent lobectomy due to NSCLC and suffering from COPD as compared to individuals without COPD has not been determined yet. The aim of the study was to compare effectiveness of post-operative PR in patients with COPD after lobectomy due to NSCLC (COPD[+] L [+]) with individuals with COPD without lung parenchyma resection (COPD(+) L(–)) and those who underwent lobectomy due to NSCLC and not suffering from COPD (COPD[–] L[+]).
Material and methods: Thirty-seven patients with non-small cell lung cancer (21 patients with and 16 patients without COPD) who underwent lobectomy and 29 subjects with COPD referred to the Lung Diseases Treatment and Rehabilitation Centre in Lodz in 2018–2019 were included in this retrospective analysis. The patients participated in a 3-week inpatient pulmonary rehabilitation (PR) program which included breathing exercises, physical workout, relaxation exercises, education, psychological support and nutrition consulting. The evaluation included lung function measurements, six-minute walking test (6MWT) and the St. George’s Respiratory Questionnaire (SGRQ) score. The results obtained before the rehabilitation were compared to those achieved after the 3-week PR program and compared between the study groups.
Results: A significant increase in the distance covered during 6MWT was observed in all the three groups studied: COPD(+) L(+) (Δ = 62.52 ± 14.58 m); COPD(–) L(+) (Δ = 73.67 ± 11.58 m); and COPD(+) L(–) (Δ = 59.93 ± 10.02 m) (p < 0.001 for all). Similarly, a statistically and clinically significant improvement in the total SGRQ score was recorded: COPD(+) L(+) ∆ = –12.05 ± 3.96 points; p < 0.05 and COPD(–) L(+) ∆ = –12.30 ± 4.85 points; p < 0.01 and COPD(+) (L–) ∆= –14.07 ± 3.36 points (p < 0.001). No significant differences in the outcome improvement between the study groups were identified.
Conclusions: The results of the study show that COPD(+) L(+) patients gained benefits from post-operative PR comparable to COPD(+) L(–) and COPD(–) L(+) subjects by improving their physical capacity and quality of life.

Abstract

Introduction: The procedure of lung parenchyma resection may result in impairment of physical capacity and quality of life. In patients with operable non-small cell lung cancer (NSCLC), lobectomy is an elective procedure. Chronic obstructive pulmonary disease (COPD) is a common coexisting condition in patients with NSCLC. Effectiveness of post-operative pulmonary rehabilitation (PR) in patients who underwent lobectomy due to NSCLC and suffering from COPD as compared to individuals without COPD has not been determined yet. The aim of the study was to compare effectiveness of post-operative PR in patients with COPD after lobectomy due to NSCLC (COPD[+] L [+]) with individuals with COPD without lung parenchyma resection (COPD(+) L(–)) and those who underwent lobectomy due to NSCLC and not suffering from COPD (COPD[–] L[+]).
Material and methods: Thirty-seven patients with non-small cell lung cancer (21 patients with and 16 patients without COPD) who underwent lobectomy and 29 subjects with COPD referred to the Lung Diseases Treatment and Rehabilitation Centre in Lodz in 2018–2019 were included in this retrospective analysis. The patients participated in a 3-week inpatient pulmonary rehabilitation (PR) program which included breathing exercises, physical workout, relaxation exercises, education, psychological support and nutrition consulting. The evaluation included lung function measurements, six-minute walking test (6MWT) and the St. George’s Respiratory Questionnaire (SGRQ) score. The results obtained before the rehabilitation were compared to those achieved after the 3-week PR program and compared between the study groups.
Results: A significant increase in the distance covered during 6MWT was observed in all the three groups studied: COPD(+) L(+) (Δ = 62.52 ± 14.58 m); COPD(–) L(+) (Δ = 73.67 ± 11.58 m); and COPD(+) L(–) (Δ = 59.93 ± 10.02 m) (p < 0.001 for all). Similarly, a statistically and clinically significant improvement in the total SGRQ score was recorded: COPD(+) L(+) ∆ = –12.05 ± 3.96 points; p < 0.05 and COPD(–) L(+) ∆ = –12.30 ± 4.85 points; p < 0.01 and COPD(+) (L–) ∆= –14.07 ± 3.36 points (p < 0.001). No significant differences in the outcome improvement between the study groups were identified.
Conclusions: The results of the study show that COPD(+) L(+) patients gained benefits from post-operative PR comparable to COPD(+) L(–) and COPD(–) L(+) subjects by improving their physical capacity and quality of life.

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Keywords

lobectomy, pulmonary rehabilitation, lung cancer, chronic obstructive pulmonary disease, 6MWT

About this article
Title

Effectiveness of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease after lobectomy due to non-small cell lung cancer — a single-center retrospective study

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 3 (2021)

Article type

Research paper

Pages

247-253

Published online

2021-06-30

DOI

10.5603/ARM.a2021.0060

Pubmed

34196376

Bibliographic record

Adv Respir Med 2021;89(3):247-253.

Keywords

lobectomy
pulmonary rehabilitation
lung cancer
chronic obstructive pulmonary disease
6MWT

Authors

Magdalena Klimczak
Damian Piekielny
Adam Antczak
Jacek Śmigielski
Damian Tworek

References (22)
  1. Loganathan RS, Stover DE, Shi W, et al. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest. 2006; 129(5): 1305–1312.
  2. Dutkowska AE, Antczak A. Comorbidities in lung cancer. Pneumonol Alergol Pol. 2016; 84(3): 186–192.
  3. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013; 188(8): e13–e64.
  4. Corhay JL, Dang DN, Van Cauwenberge H, et al. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis. 2014; 9: 27–39.
  5. McCarthy B, Casey D, Devane D, et al. PRINCE study team. A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD): The PRINCE Study protocol. BMC Pulm Med. 2011; 11(10): 4.
  6. Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, et al. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2016; 23(3): 486–497.
  7. Arbane G, Douiri A, Hart N, et al. Effects of postoperative physical training on activity after curative surgery for non-small cell lung cancer. Physiotherapy. 2014; 100(2): 100–107.
  8. Kim SK, Ahn YH, Yoon JA, et al. Efficacy of Systemic Postoperative Pulmonary Rehabilitation After Lung Resection Surgery. Ann Rehabil Med. 2015; 39(3): 366–373.
  9. Mainini C, Rebelo PFs, Bardelli R, et al. Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence? SAGE Open Med. 2016; 4: 2050312116673855.
  10. Miller MR, Hankinson J, Brusasco V, et al. ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005; 26(2): 319–338.
  11. Przybyłowski T, Tomalak W, Siergiejko Z, et al. Polish Respiratory Society guidelines for the methodology and interpretation of the 6 minute walk test (6MWT). Pneumonol Alergol Pol. 2015; 83(4): 283–297.
  12. Redelmeier DA, Bayoumi AM, Goldstein RS, et al. Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. Am J Respir Crit Care Med. 1997; 155(4): 1278–1282.
  13. Jones PW, Quirk FH, Baveystock CM, et al. The St George's Respiratory Questionnaire. Respir Med. 1991; 85 Suppl B(6): 25–31; discussion 33.
  14. Corhay JL, Dang DN, Van Cauwenberge H, et al. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis. 2014; 9: 27–39.
  15. Puhan MA, Gimeno-Santos E, Cates CJ, et al. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011; 12(10): CD005305.
  16. Postmus PE, Kerr KM, Oudkerk M, et al. ESMO Guidelines Committee. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017; 28(suppl_4): iv1–iv21.
  17. Celli BR. Chronic respiratory failure after lung resection: the role of pulmonary rehabilitation. Thorac Surg Clin. 2004; 14(3): 417–428.
  18. Jones LW, Peddle CJ, Eves ND, et al. Effects of presurgical exercise training on cardiorespiratory fitness among patients undergoing thoracic surgery for malignant lung lesions. Cancer. 2007; 110(3): 590–598.
  19. Bobbio A, Chetta A, Ampollini L, et al. Preoperative pulmonary rehabilitation in patients undergoing lung resection for non-small cell lung cancer. Eur J Cardiothorac Surg. 2008; 33(1): 95–98.
  20. Benzo R, Wigle D, Novotny P, et al. Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer. 2011; 74(3): 441–445.
  21. Edvardsen E, Skjønsberg OH, Holme I, et al. High-intensity training following lung cancer surgery: a randomised controlled trial. Thorax. 2015; 70(3): 244–250.
  22. Vagvolgyi A, Rozgonyi Z, Kerti M, et al. Effectiveness of perioperative pulmonary rehabilitation in thoracic surgery. J Thorac Dis. 2017; 9(6): 1584–1591.

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