Low forced vital capacity predicts poor prognosis in gastric cancer patients.

Fan Feng,Hongwei Zhang,Yangzi Tian,Man Guo,Li Sun,Liu Hong,Jianjun Yang,Yuan Zang,Xiao Lian,Daiming Fan

doi:10.18632/oncotarget.15953

Abstract

Preoperative pulmonary function assessment is used to select surgical candidates and predict the occurrence of postoperative complications. The present study enrolled 1210 gastric cancer patients (949 males and 261 females). Forced vital capacity (FVC) and maximal voluntary ventilation (MVV) were measured as a percent of predicted values. We then analyzed associations between patient pulmonary function and both prognosis and postoperative complications. Patient 1-, 3- and 5-year overall survival rates were 88.8%, 65.7% and 53.0%, respectively. FVC and MVV optimal cutoff values were 87.0 (P=0.003) and 83.6 (P=0.026), respectively. Low FVC and low MVV were associated with higher rates of postoperative fever (23.8% vs. 13.9%, P<0.001; 17.8% vs. 13.3%, P=0.049, respectively) and poor patient prognosis (5-year overall survival: 43.5% vs. 57.6%, P=0.003; 51.8% vs. 54.3%, P=0.026, respectively). Only low FVC was an independent prognostic predictor for gastric cancer (P=0.012). In subgroup analyses, FVC was not associated with stage I or II gastric cancer patient prognoses (P>0.05), but low FVC was an independent risk factor for poor prognosis in stage III gastric cancer cases (P=0.004). These findings indicate that low FVC is predictive of poorer prognosis and higher risk of postoperative fever in gastric cancer patients.

Highlights

Gastric cancer is the fifth most common malignancy, and the third leading cause of cancer-related death worldwide [1], incidences have declined in recent decades
Low Forced vital capacity (FVC) and low maximal voluntary ventilation (MVV) were associated with higher rates of postoperative fever (23.8% vs. 13.9%, P
We found that FVC level was associated with gender, age, body mass index (BMI), albumin, tumor size, and tumor stage (P

Summary

Introduction

Gastric cancer is the fifth most common malignancy, and the third leading cause of cancer-related death worldwide [1], incidences have declined in recent decades. Even with advances in surgical techniques and adjuvant therapy options, advanced gastric cancer patient prognoses are poor [2]. Surgeons commonly encounter patients with impaired pulmonary function during preoperative evaluation. Pulmonary comorbidity increases the risk of postoperative respiratory complications [3]. Preoperative evaluation of pulmonary function is widely used to select surgical candidates and predict the occurrence of postoperative respiratory complications, especially in the field of thoracic surgery [4]. Recent studies investigated the influence of pulmonary function on abdominal surgery outcomes [5, 6]. The prognostic value of preoperative pulmonary function in gastric cancer patients has not yet been investigated. The present study assessed the value of pulmonary function in predicting gastric cancer patient prognosis and the likelihood of postoperative complications

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Results

Conclusion