Influencing factors of FEV 1 and FVC for primary lung cancer patients (original) (raw)
Related papers
Physiologic Evaluation of the Patient With Lung Cancer Being Considered for Resectional Surgery
CHEST Journal, 2013
This section of the guidelines is intended to provide an evidence-based approach to the preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer. The current guidelines and medical literature applicable to this issue were identified by computerized search and were evaluated using standardized methods. Recommendations were framed using the approach described by the Guidelines Oversight Committee. The preoperative physiologic assessment should begin with a cardiovascular evaluation and spirometry to measure the FEV1 and the diffusing capacity for carbon monoxide (Dlco). Predicted postoperative (PPO) lung functions should be calculated. If the % PPO FEV1 and % PPO Dlco values are both > 60%, the patient is considered at low risk of anatomic lung resection, and no further tests are indicated. If either the % PPO FEV1 or % PPO Dlco are within 60% and 30% predicted, a low technology exercise test should be performed as a screening test. If performance on the low technology exercise test is satisfactory (stair climbing altitude > 22 m or shuttle walk distance > 400 m), patients are regarded as at low risk of anatomic resection. A cardiopulmonary exercise test is indicated when the PPO FEV1 or PPO Dlco (or both) are < 30% or when the performance of the stair-climbing test or the shuttle walk test is not satisfactory. A peak oxygen consumption (V˙O2 peak) < 10 mL/kg/min or 35% predicted indicates a high risk of mortality and long-term disability for major anatomic resection. Conversely, a V˙O2 peak > 20 mL/kg/min or 75% predicted indicates a low risk. A careful preoperative physiologic assessment is useful for identifying those patients at increased risk with standard lung cancer resection and for enabling an informed decision by the patient about the appropriate therapeutic approach to treating his or her lung cancer. This preoperative risk assessment must be placed in the context that surgery for early-stage lung cancer is the most effective currently available treatment of this disease.
Signa Vitae, 2020
Introduction: Three ways of simple calculations (segmental based on 18 segments method, segmental based on 19 segments method and subsegmental method) of predictive postoperative values of FEV1 and DLCO are in use during the preoperative survey for patients planned for lung resection as treatment of lung carcinoma as a part of risk assessment. Hypothesis: Segmental calculation method based on 19 segments is better than subsegmental method and segmental calculation method based on 18 segments in prediction of postoperative values of both FEV1 and DLCO one month after lung lobectomy. Materials and methods: Expected postoperative calculated values of FEV1 and DLCO (two segmental and one subsegmental method) of 52 patients undergone lobectomy are related to real postoperative values for same patients one month after surgery. Results: According to univariate analysis, real values of postoperative DLCO correlate most significantly with ppoDLCO calculated by segmental method (18 segments),...
Journal of thoracic disease, 2018
Despite the importance of preoperative risk-stratification, there is a lack of consensus on how to identify high-risk patients for pulmonary resection. Enrollment criteria for national trials propose one definition based on preoperative pulmonary function tests. We sought to examine the value of preoperative forced expiratory volume in 1 second (FEV1) and diffusion capacity for carbon monoxide (DLCO) to predict short-term outcomes following pulmonary resection. Using our institutional Society of Thoracic Surgeons (STS) database we identified 419 consecutive lung cancer patients who presented to our institution for pulmonary resection between 2012 and 2016. We identified patients as "high risk" based on the national trial criteria of FEV1 or DLCO ≤50%. Our primary outcome was any postoperative complication within 30 days of surgery. Secondary outcomes included cardiac and pulmonary complications, 30-day readmission, and discharge disposition. DLCO ≤50% was associated with a...