The relationship between family-associated factors and the postoperative prognosis is unknown in patients with non-small cell lung cancer (NSCLC). We hypothesized that family-associated support was associated with postoperative prognosis via nutritional pathway. The aim of this study is to elucidate the relationship between family-associated factors and postoperative prognosis in patients with NSCLC.
We selected 195 patients with NSCLC who underwent curative surgery between 2005 and 2010 whose computed tomography images within 1 month preoperatively and after 1 year postoperatively were available. The nutritional indices such as prognostic nutritional index (PNI), controlling nutritional status (CONUT), modified Glasgow prognostic score (mGPS) and skeletal muscle area (SMA) were used to estimate the change in nutritional condition after 1 year postoperatively. Paravertebral muscle area at the 12th thoracic vertebra level was used to analyze the SMA.
One hundred and forty-four patients (73.8%) had both children and a partner. Twenty-seven (13.8%) only had children and 14 (7.2%) only had a partner. Childless patients showed a significantly shorter overall survival (OS) and disease-free survival (DFS) than those with children (p<0.05 and p<0.05, respectively). The postoperative exacerbation of PNI, CONUT, mGPS and SMA were found to be significantly correlated with childless patients compared with those with children (p=0.002,p=0.001,p<0.001 and p=0.029, respectively). Childless patients with a partner showed a particularly shorter OS and DFS than those with children (p<0.001 and p<0.001, respectively). The childless patients with a partner showed significant postoperative exacerbation of PNI, CONUT, mGPS and SMA compared with those with children (p=0.037,p<0.001,p<0.001 and p=0.039, respectively).
The patients without any children had a significantly poorer postoperative prognosis than those with children. The childless partner-present patients showed a particularly shorter OS and DFS than those with children. It was suggested that the childless patients were significantly associated with postoperative exacerbation of the nutritional status.
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All authors have declared no conflicts of interest.