title: Long-term survival analysis of the Canadian Lung Volume Reduction Surgery trial.
abstract: BACKGROUND
  The Canadian Lung Volume Reduction Surgery (CLVRS) trial was a multicentered randomized controlled trial that concluded that lung volume reduction surgery improves functional status and health-related quality of life (for at least 2 years) in selected patients with advanced emphysema.
  
  
  METHODS
  This retrospective observational study assessed the long-term survival of patients enrolled in the CLVRS at 8 to 10 years after randomization. Vital statistics were gathered through telephone contact, physician records, and municipal obituaries. Survival analysis was undertaken using Kaplan-Meier and the Cox proportional hazards models.
  
  
  RESULTS
  Fifty-two patients (84% of the initial 62 patients randomized) had a median survival time of 4.11 years. A 16-month survival advantage and a 20% reduction in mortality was observed in the LVRS group as compared with the best medical care group. Although clinically meaningful, these differences were not statistically significant.
  
  
  CONCLUSIONS
  These findings echo those of other published reports and demonstrate the potential long-term benefit of LVRS in the treatment of end-stage emphysema.
authors.affiliation: Division of Thoracic Surgery, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Agzarian
authors.affiliation: Division of Thoracic Surgery, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada. Electronic address: jmiller@mcmaster.ca.
authors.forename: John D
authors.initials: JD
authors.lastname: Miller
authors.affiliation: Division of Health Research Methodology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Kosa
authors.affiliation: Division of Thoracic Surgery, University of Western Ontario, Victoria Hospital, London, Ontario, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.affiliation: Division of Thoracic Surgery, University of Manitoba Health Sciences Centre, Winnipeg, Manitoba, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Tan
mesh_terms: D000368:Aged; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000401:mortality / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
keywords: 11