Video-assisted thoracic surgery pulmonary resection for lung cancer in patients with poor lung function

Ann Thorac Surg. 2006 Jun;81(6):1996-2003. doi: 10.1016/j.athoracsur.2006.01.038.

Abstract

Background: The aim of this study is to evaluate the early outcome of patients with poor lung function who underwent video-assisted thoracic surgery (VATS) pulmonary resection for primary non-small cell lung carcinoma.

Methods: We reviewed retrospectively the records of patients with lung cancer undergoing VATS lung resection over a period of 5 years. Twenty-five patients with preoperative poor lung function defined as forced expiratory volume in 1 second less than 0.8 L or the percentage predicted value for forced expiratory volume in 1 second less than 50% were identified. Thirteen patients underwent VATS lobectomies and 12 VATS wedge resections. Data were analyzed with respect to demographics, risk factors, and early postoperative outcome and survival.

Results: There were 8 cases of morbidities (29%) and no surgical mortality. Five of these 8 patients had respiratory-related complications after surgery. A deterioration in pulmonary performance as indicated by the Eastern Cooperative Oncology Group (ECOG) score was seen in 7 patients (28%), with only 1 patient having an ECOG score greater than 2. No patient required home oxygen supplementation beyond the third month postoperatively. After a median follow-up period of 15.1 months (range, 1 to 24), 5 patients died. Only 1 patient (4%) died of a respiratory complication (pneumonia 6 weeks after surgery). The other 4 deaths were due to recurrent or metastatic disease. The actuarial survival rates at 1 and 2 years were 80% and 69%, respectively.

Conclusions: Video-assisted thoracic surgery pulmonary resection for cancer in patients with poor lung function can achieve acceptable functional and oncologic outcome.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / physiopathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Combined Modality Therapy
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume*
  • Humans
  • Life Tables
  • Lung Neoplasms / mortality
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / surgery*
  • Lung Neoplasms / therapy
  • Male
  • Neoadjuvant Therapy
  • Neoplasm Metastasis
  • Pneumonectomy / methods*
  • Pneumonectomy / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Smoking / epidemiology
  • Survival Analysis
  • Survival Rate
  • Thoracic Surgery, Video-Assisted* / statistics & numerical data
  • Treatment Outcome