Background: Few studies have examined the differential impact of sublobar resection (SL) and lobectomy (L) on quality of life (QoL) during the first postoperative year. Methods:We used a prospective cohort of Stage IA lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS) from the Initiative for Early Lung Cancer Research on Treatment. QoL was measured before surgery, and within 4, 6, and 12 months post-surgery using three validated instruments: SF-12 [physical (PCS) and mental health (MCS)], FACT-LCS (lung-cancer-symptoms), and the PHQ-4 (anxiety and depression subscales). Locally weighted smoothing curve (LOWESS) was fitted to identify the best interval knot for the change in the QoL trend post-surgery. After adjusting for demographic and clinical variables, an adjusted piecewise linear mixed effects model was developed to estimate differences in baseline and 12-month scores, and rates of change for each QoL measure. Results: SL resection was performed in 127 (63.2%) and L in 74 (36.8%) patients. LOWESS plots suggested that the shift of QoL (interval knot) was at 2 months post-surgery. Decreases in PCS scores were less severe for SL than L patients 2 months post-surgery (−0.18 vs. −2.30, P=0.02); while subsequent improvements were observed for both groups (SL: +0.

It was feasible to obtain pre- and postsurgical information from patients and surgeons. We anticipate statistically meaningful results about treatment alternatives in 3 to 5 years.

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The unnecessary referral rate will be compared between the NELCIN-B3 and standard protocol for early detected lung nodules management. The effectiveness of quantitative measurement of CT imaging biomarkers for early detection of lung cancer, COPD and CVD will be evaluated. Conclusion: We expect that the quantitative assessment of the CT imaging biomarkers will reduce the number of unnecessary referrals for early detected lung nodules and improve the early detection of COPD and CVD in Chinese urban populations.