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Original research
Long-term incidence of chronic postsurgical pain after thoracic surgery for lung cancer: a 10-year single-center retrospective study
  1. Susie Yoon1,2,
  2. Won-Pyo Hong1,
  3. Hyundeok Joo3,
  4. Hansol Kim1,
  5. Samina Park4,5,
  6. Jae-Hyon Bahk1,2 and
  7. Ho-Jin Lee1,2
  1. 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, The Republic of Korea
  2. 2Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea
  3. 3Seoul National University College of Medicine, Seoul, The Republic of Korea
  4. 4Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, The Republic of Korea
  5. 5Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, The Republic of Korea
  1. Correspondence to Dr Ho-Jin Lee, Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea; zenerdiode03{at}gmail.com

Abstract

Background The long-term incidence of chronic postsurgical pain (CPSP) after thoracic surgery has not yet been reported.

Methods We retrospectively reviewed the electronic medical records of 4218 consecutive patients who underwent thoracic surgery for lung cancer between 2007 and 2016. We evaluated the long-term incidence of CPSP after thoracic surgery at intervals of 3 months for 36 months. A Cox proportional hazard regression analysis was performed to investigate the predictors of CPSP after thoracic surgery.

Results A total of 3200 patients were included in the analysis. Of these, 459 (14.3%) and 558 (17.4%) patients were diagnosed with CPSP within 3 and 36 months after surgery, respectively. Furthermore, the incidence of CPSP decreased over time. Additionally, 99 (3.1%) patients were newly diagnosed with CPSP at least 6 months after surgery. Female sex (HR 1.20, 95% CI 1.00 to 1.43; p=0.04), longer duration of surgery (HR 1.11, 95% CI 1.03 to 1.20; p<0.01), higher 11-point Numeric Rating Scale score at first outpatient visit after surgery (HR 1.29, 95% CI 1.24 to 1.34; p<0.001), postoperative chemotherapy (HR 1.55, 95% CI 1.26 to 1.90; p<0.001), and postoperative radiation therapy (HR 1.35, 95% CI 1.05 to 1.74; p=0.02) were significant predictors of CPSP for 36 months after surgery.

Conclusion Our study showed a decreasing trend in the incidence of CPSP as well as delayed-onset or recurrent CPSP after thoracic surgery. A better understanding of the progression of CPSP after thoracic surgery may provide important information on its prediction and treatment.

  • chronic pain
  • postoperative pain
  • thoracic surgery

https://doi.org/10.1136/rapm-2020-101292

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    Footnotes

    • Contributors SY: data collection, statistical analysis, manuscript preparation. W-PH: data collection, manuscript revision. HJ: data collection. HK: data collection, manuscript revision. SP: manuscript revision. J-HB: manuscript revision. HJL: study design, statistical analysis, manuscript preparation, manuscript revision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The institutional review board (IRB) of Seoul National University Hospital approved this retrospective cohort study (IRB no 2001-005-1090). All methods were carried out in accordance with the approved guidelines.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Deidentified participant data are available upon reasonable request.