Impact of trimodality treatment on patient quality of life and arm function for superior sulcus tumors

BACKGROUND: Trimodality treatment leads to improved survival for superior sulcus tumor (SST) patients. Not much is known about the impact of this treatment on arm function and patient quality of life.

OBJECTIVE: To analyze arm function and quality of life in SST patients undergoing trimodality treatment.

METHODS: This was a prospective cohort study of consecutive SST patients treated with trimodality treatment that was conducted between April 1, 2010 and October 31, 2012. We obtained informed consent for 20 of 22 eligible patients. The 36-item Short Form Health Survey (SF-36) and disabilities of the arm, shoulder, and hand (DASH) questionnaires were used to asses patient quality of life and subjective arm function at 0 (preoperative day), 3, and 12 months after trimodality treatment.

RESULTS: DASH scores were significantly lower at 3 and 12 months ( d443; = .024 and d443; = .011) compared with preoperative scores. Significantly lower scores were reported for the SF-36 domains of physical functioning at 12 months ( d443; = .020) and of physical role functioning at 3 months ( d443; = .041), and significantly more pain was reported at 3 and 12 months ( d443; = .006 and d443; = .019, respectively). Patients who underwent T1 nerve root resection had lower scores for the SF-36 domain health change at 3 months ( d443; = .037) compared with those in whom the T1 root was spared. For all other domains no differences were found.

LIMITATIONS: Small sample size; patient pre-chemoradiation function and quality of life unknown.

CONCLUSION: Subjective arm function and patient quality of life is reduced following trimodality treatment. Resection of the T1 nerve root has no significant long-term effect on the subjective arm function and quality of life.