Lung cancer, which remains one of the deadliest cancers worldwide, often requires surgical intervention as a primary curative approach. Despite advances in surgical methods and perioperative management, patients frequently face significant challenges during postoperative recovery, particularly regarding symptom burden. A new multicenter cohort study published recently is shedding light on how biological sex influences these postoperative experiences, offering a potential shift in how recovery is managed for lung cancer patients.
The study draws on data from the CN-PRO-Lung 1 cohort, which included 372 adult patients undergoing lung cancer surgery across multiple centers. Using the MD Anderson Symptom Inventory specifically adapted for lung cancer, researchers collected daily patient-reported data on various postoperative symptoms from pre-surgery baseline until discharge, usually within a week. This detailed, day-by-day tracking of symptoms provided an unprecedented look at the dynamic recovery patterns among these patients.
Results from the research reveal that women consistently report higher symptom severity than men in the acute postoperative phase. These symptoms spanned several areas such as pain, fatigue, shortness of breath, loss of appetite, dry mouth, and constipation, indicating a broader burden of discomfort in female patients. Such findings challenge the notion of uniform postoperative care and suggest that current protocols may inadequately address the nuanced needs of different patient groups based on sex.
Pain management, a vital aspect of postoperative recovery, exhibited notable sex-specific differences. While both men and women showed decreasing pain trends over the days post-surgery, the factors contributing to heightened pain varied. For male patients, worse physical health status before surgery—measured by the ASA classification—more advanced tumor stages, and the presence of multiple chest drains were linked to increased pain intensity. Conversely, in female patients, the performance of systematic lymph node dissection during surgery was more strongly associated with higher pain levels, highlighting distinct surgical impact and risk profiles between sexes.
Understanding these diverging risk factors can have meaningful clinical implications. Tailoring pain control and supportive care strategies in a sex-specific manner may enhance the effectiveness of postoperative management. For example, men with advanced disease or higher perioperative risk might benefit from proactive multimodal pain protocols, whereas women undergoing extensive lymph node dissection could require specialized monitoring and interventions focused on mitigating related pain and other symptoms.
Beyond physical aspects, the study acknowledges the complex biological and psychosocial contributors to these differences. Variations in immune response, hormonal regulation, and pain perception influenced by sex hormones may partly explain the differential symptom burden. Moreover, gender-related behavioral and psychological factors could affect symptom reporting and experience, suggesting the interplay of biopsychosocial mechanisms in recovery trajectories.
Methodologically, the researchers employed linear mixed-effect models, which allowed them to account for repeated daily measures and individual variability among patients. This robust statistical approach enabled the capture of subtle symptom changes over time and their associations with clinical variables, providing a dynamic and comprehensive portrayal of postoperative recovery far beyond traditional single-point evaluations.
The findings urge oncologists, thoracic surgeons, and perioperative teams to reconsider standard postoperative care pathways. Integrating sex as a core element in risk stratification and symptom management could lead to more personalized, patient-centered care. Such an approach not only promises to improve symptom control but also offers potential gains in patient satisfaction and overall quality of life during the crucial early recovery period.
Additionally, the study reinforces the value of incorporating patient-reported outcomes (PROs) into surgical oncology research and clinical practice. PROs illuminate the patient’s perspective, uncovering subjective symptom patterns that conventional clinical metrics may fail to capture. This patient-centric data is crucial for refining treatment protocols and ensuring that recovery support addresses what matters most to patients.
Looking forward, further research exploring the biological mechanisms behind sex-specific symptom differences is warranted. Tools like genomic sequencing, proteomics, and neurophysiological assessments could reveal the molecular pathways underlying these disparities, enabling targeted interventions. Moreover, extending follow-up assessments beyond hospital discharge would clarify whether these symptom differences persist long-term, informing survivorship care plans that anticipate and mitigate chronic symptom burdens.
The relevance of these findings is heightened by current trends toward minimally invasive lung cancer surgeries, which aim to minimize postoperative morbidity. Understanding sex-related differences in recovery can guide enhancements in these evolving surgical techniques and inform tailored patient education and enhanced recovery after surgery (ERAS) protocols, ultimately enhancing outcomes.
In summary, this multicenter cohort study pioneers a deeper understanding of how sex influences postoperative symptom burden in lung cancer surgery patients. It advocates for a paradigm shift toward individualized postoperative management strategies that recognize and respond to the distinct recovery needs of men and women. Embracing sex as a fundamental variable in surgical oncology care exemplifies the broader movement toward precision medicine, promising more equitable and effective treatment for lung cancer patients globally.
As the burden of lung cancer continues to rise worldwide, integrating these insights into clinical practice protocols is imperative. Clinicians, researchers, and policymakers must collaborate to embed sex-informed care in the perioperative landscape, ensuring that all patients receive optimized support tailored to their unique recovery journeys. This approach not only aligns with patient-centered values but also holds the potential to improve short- and long-term outcomes for the growing lung cancer population.
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**Araştırma Konusu**:
Sex-related differences in postoperative patient-reported outcomes among lung cancer patients
**Makale Başlığı**:
Sex-related differences in postoperative patient-reported outcomes among lung cancer patients: a multicenter cohort study
**Web References**:
https://doi.org/10.1186/s12885-025-14191-z
**Doi Referans**:
https://doi.org/10.1186/s12885-025-14191-z
**Resim Credits**:
Scienmag.com
**Anahtar Kelimeler**:
acute postoperative phase recovery patterns, biological sex influence on postoperative care, CN-PRO-Lung 1 multicenter cohort study, gender disparities in symptom burden after surgery, gender-specific postoperative care paradigms, lung cancer surgical intervention effectiveness, MD Anderson Symptom Inventory for lung cancer, nuanced analyses of symptom trajectories in cancer recovery, patient-reported outcomes in lung cancer treatment, postoperative recovery trajectories in lung cancer, sex differences in lung cancer surgery outcomes, symptom management in lung cancer patients
