Preoperative evaluation and risk factors of lung cancer.
Based on a review of the literature on resectable lung cancer, pulmonary risk factors before, during and after surgery are discussed. The role of preoperative evaluation in order to determine the patient ability to withstand radical resection is considered. Spirometric indexes as forced expired volume (FEV1) and diffusing lung carbon monoxide capacity (DLCO) should be measured first. If FEV1 and DLCO are > 60% of predicted, patients are at low risk for complications and can undergo pulmonary resection. However, if FEV1 and DLCO are <60% of predicted, further evaluation with a quantitative lung scan is required. If predicted postoperative values for FEV1 and DLCO are >40%, patients can undergo lung resection, otherwise exercise testing is necessary. If the latter shows maximal oxygen uptake (VO2max) of > 15ml/Kg, surgery can be performed; if VO2max is <15 ml/Kg, patients are inoperable.
Gaballo
Annarita
A
Fisiopatologia Respiratoria, Istituto di Medicina Interna e Geriatria Università Cattolica del S. Cuore, Policlinico "A. Gemelli", Roma, Italy. agaballo@yahoo.it
Corbo
Giuseppe M
GM
Valente
Salvatore
S
Ciappi
Giuliano
G
D005080:Exercise Test; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D018579:Patient Selection; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012129:Respiratory Function Tests; D012307:Risk Factors