Optics

Physics

Internal medicine

Surgery

Cardiothoracic surgery

Retrospective cohort study

Hazard ratio

Lung cancer

Lung cancer surgery

Confidence interval

Proportional hazards model

Incidence (geometry)

Medicine

Regional Anesthesia & Pain Medicine

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&lt;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&lt;0.001), postoperative chemotherapy (HR 1.55, 95% CI 1.26 to 1.90; p&lt;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.

Long-term incidence of chronic postsurgical pain after thoracic surgery for lung cancer: a 10-year single-center retrospective study