title: Pulmonary function tests as a predictor of quantitative and qualitative outcomes after thoracic surgery for lung cancer.
abstract: BACKGROUND
  Pulmonary function tests are used to select patients with non-small-cell lung cancer (NSCLC) suitable for thoracic surgery. We studied the impact of pulmonary function tests on both quantitative (morbidity, mortality, and overall survival [OS]) and qualitative (quality of life [QOL]) outcomes of patients undergoing thoracic surgery for NSCLC.
  
  
  METHODS
  Patients with proven or highly probable NSCLC referred for thoracic surgery were eligible. The postoperative outcomes morbidity, 90-day mortality, OS, and QOL based on PGWBI and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 were studied according to the results of the preoperative pulmonary function tests (forced expiratory volume in 1 second [FEV(1)]; vital capacity, residual volume, total lung capacity, airways resistance, diffusing capacity corrected for alveolar volume).
  
  
  RESULTS
  A total of 110 patients were studied, with 94 patients eligible for analysis. Postoperative mortality and morbidity affected 9.5% and 40% of patients, respectively. These patients presented with significantly lower preoperative values of vital capacity, total lung capacity, and diffusing capacity corrected for alveolar volume and higher preoperative values of airways resistance compared with patients with an uncomplicated postoperative course. Better survival was correlated with higher preoperative values of FEV(1), vital capacity, total lung capacity, and a lower pulmonary distension, especially when expressed as a percentage of predicted value. None of the postoperative QOL scores was influenced by preoperative pulmonary function tests results.
  
  
  CONCLUSIONS
  Pulmonary function tests allow a relatively good prediction of postoperative quantitative outcomes such as postoperative morbidity and mortality as well as OS after thoracic surgery for NSCLC. However, pulmonary function tests remain poorly correlated to postoperative qualitative outcomes, making QOL a separate and essential assessment of the health status of patients with resected NSCLC.
authors.affiliation: Department of Thoracic Oncology, Université de la Méditerranée - Assistance Publique, Hôpitaux de Marseille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Greillier
authors.forename: Pascal
authors.initials: P
authors.lastname: Thomas
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.forename: Christophe
authors.initials: C
authors.lastname: Doddoli
authors.forename: Monique
authors.initials: M
authors.lastname: Badier
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Fabrice
authors.initials: F
authors.lastname: Barlési
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000517:prevention & control; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012129:Respiratory Function Tests; D016019:Survival Analysis; D016896:Treatment Outcome