Peak oxygen consumption measurement and postoperative outcome in patients with early-stage lung cancer

Abstract

INTRODUCTION: In early-stage lung cancer (LC) patients, the best survival rates are achieved when the patient undergoes surgical resection. Cardiopulmonary exercise testing is an important preoperative test because of its ability to detect disturbance in the oxygen transport system, which is, in turn, related to the development of postoperative complications. OBJECTIVES: The aim of the study is to investigate the value of peak oxygen consumption (peakVO2) to determine postoperative pulmonary complications (PPCs) in LC patients with surgical resection. MATERIALS AND METHODS: LC patients who were candidates for surgery between February 2015 and 2017 were included in this prospectively conducted study. PeakVO2 measurement was performed by utilizing cycle ergometry during incremental exercise. All patients were on follow-up for PPCs for a period of 30 days postoperatively. RESULTS: The study included 41 patients (mean age: 63.9 ± 9.7 years) who had undergone surgical resection (28 lobectomies/13 pneumonectomies). There was no mortality, but 8 (19.5%) PPCs were observed. Mean peakVO2 values were not different in patients with and without PPCs. When the patients were divided into two groups based on absolute forced expiratory volume 1 second (FEV1) (≤1.5 L and >1.5 L) and ppo FEV1% (≤30% and >30%); mean peakVO2, mean stay days in intensive care unit and hospital, and PPC rates were similar between groups. Fourteen patients with FEV1≤1.5 L and 11 patients with ppo FEV1≤30% underwent successful surgical resections. CONCLUSION: PeakVO2 measurement prevents patients to be deprived of a surgical resection, which is an important treatment modality for LC. PPCs were in acceptable limits in patients with a value of peakVO2≥15 ml/kg/min.