title: Does lobectomy for lung cancer in patients with chronic obstructive pulmonary disease affect lung function? A multicenter national study.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effect of lobectomy on pulmonary function in patients with chronic obstructive pulmonary disease.
  
  
  METHODS
  One hundred thirty-seven patients were analyzed; 49 had normal pulmonary function tests, and 88 had chronic obstructive pulmonary disease. Different functional parameter groups were identified: obstructive (forced expiratory volume in 1 second [FEV1], forced expiratory volume in 1 second/forced vital capacity [FEV1/FVC], and chronic obstructive pulmonary disease index), hyperinflation (residual volume and functional residual capacity), and diffusion (transfer factor of the lung for carbon monoxide). Also, the ratio between observed and predicted postoperative FEV(1) was calculated.
  
  
  RESULTS
  In patients with preoperative FEV1 greater than 80% of predicted, postoperative FEV1/FVC slightly but not significantly decreased, and postoperative FEV1 significantly decreased. In patients with preoperative FEV1 less than 65%, postoperative FEV1 and FEV1/FVC significantly increased. In patients with preoperative FEV1/FVC greater than 70%, postoperative FEV1 and FEV1/FVC significantly decreased. In patients with preoperative FEV1/FVC less than 70%, postoperative FEV1/FVC increased, and FEV1 remained unchanged. In patients with a chronic obstructive pulmonary disease index greater than 1.5, postoperative FEV1 and FEV1/FVC significantly decreased, whereas in patients with a chronic obstructive pulmonary disease index less than 1.5, postoperative FEV1/FVC significantly increased and FEV1 remained unchanged. In patients with residual volume and functional residual capacity greater than 115% and transfer factor of the lung for carbon monoxide less than 80% of predicted, postoperative FEV1 diminished less (not significant) compared with patients who had residual volume and functional residual capacity less than 115% (P = .0001). Observed postoperative/predicted postoperative FEV1 was higher if FEV1/FVC was less than 55% (1.46), if FEV1 was less than 80% of predicted (1.21), or if the chronic obstructive pulmonary disease index was less than 1.5 (1.17).
  
  
  CONCLUSIONS
  Patients with mild to severe chronic obstructive pulmonary disease could have a better late preservation of pulmonary function after lobectomy than healthy patients.
authors.affiliation: Pulmonary Division, University Hospital S. Giovanni Battista of Torino, Torino, Italy. baldi_sergio@hotmail.com
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldi
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.forename: Sergio
authors.initials: S
authors.lastname: Harari
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Roviaro
authors.forename: Mario
authors.initials: M
authors.lastname: Nosotti
authors.forename: Nadia
authors.initials: N
authors.lastname: Bellaviti
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.forename: Daniele
authors.initials: D
authors.lastname: Diso
authors.forename: Federico
authors.initials: F
authors.lastname: Rea
authors.forename: Claudio
authors.initials: C
authors.lastname: Schiraldi
authors.forename: Alberto
authors.initials: A
authors.lastname: Durigato
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pavanello
authors.forename: Angelo
authors.initials: A
authors.lastname: Carretta
authors.forename: Piero
authors.initials: P
authors.lastname: Zannini
mesh_terms: D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology*; D012189:Retrospective Studies; D014797:Vital Capacity