Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most frequently occurring concomitant diseases in patients with non-small cell lung cancer (NSCLC). It is characterized by small airways and the hyperinflation of the lung. Patients with hyperinflated lung tend to have more reserved lung function than conventionally predicted after lung cancer surgery. The aim of this study was to identify other indicators in predicting postoperative lung function after lung resection for lung cancer. Patients with NSCLC who underwent curative lobectomy with mediastinal lymph node dissection from 2017 to 2019 were included. Predicted postoperative FEV1 (ppoFEV1) was calculated using the formula: preoperative FEV1 × (19 segments-the number of segments to be removed) ÷ 19. The difference between the measured postoperative FEV1 and ppoFEV1 was defined as an outcome. Patients were categorized into two groups: preserved FEV1 if the difference was positive and non-preserved FEV1, if otherwise. In total, 238 patients were included: 74 (31.1%) in the FEV1 non-preserved group and 164 (68.9%) in the FEV1 preserved group. The proportion of preoperative residual volume (RV)/total lung capacity (TLC) ≥ 40% in the FEV1 non-preserved group (21.4%) was lower than in the preserved group (36.1%) (p = 0.03). In logistic regression analysis, preoperative RV/TLC ≥ 40% was related to postoperative FEV1 preservation. (adjusted OR, 2.02, p = 0.041). Linear regression analysis suggested that preoperative RV/TLC was positively correlated with a significant difference. (p = 0.004) Preoperative RV/TLC ≥ 40% was an independent predictor of preserved lung function in patients undergoing curative lobectomy with mediastinal lymph node dissection. Preoperative RV/TLC is positively correlated with postoperative lung function.
Highlights
This article is an open access articleLung cancer can be classified into two major classes: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) [1]
A total of 238 patients with primary lung cancer who received a curative lobectomy with mediastinal lymph node dissection and did not relapse up to 12 months after surgery were included
We found that residual volume (RV)/total lung capacity (TLC) was a prognostic indicator for predicting postoperative lung function by comparing the postoperative measured FEV1 with the conventional method of prediction and that it can be calculated using a simple formula [11]
Summary
This article is an open access articleLung cancer can be classified into two major classes: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) [1]. Chronic obstructive pulmonary disease (COPD) is an important risk factor for lung cancer and is one of the most frequently occurring concomitant diseases in patients with lung cancer [3,4]. Lung volume reduction surgery (LVRS) is an accepted therapeutic option for patients with severe emphysema to relieve symptoms such as dyspnea and increased work of breathing. Spiration valve system (SVS) is a bronchoscopic lung volume reduction therapy, and it results in significant improvements in postoperative forced expiratory volume in one second (FEV1 ) and symptoms [6,7,8]. In order to predict postoperative lung function, the results of these studies indicating that reducing lung volume improves postoperative lung function should be considered
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