Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection.
Lung resection is still the only potentially curative therapy for patients with localized non-small lung cancer (NSCLC). However, the presence of cardiovascular comorbidities and underlying lung disease increases the risk of postoperative complications. Various studies have evaluated the use of different preoperative tests in order to identify patients with an increased risk for postoperative complications, associated with prolonged hospital stay and increased morbidity and mortality. In this topic review, we discuss the role of cardiopulmonary exercise testing (CPET) as one of the preoperative tests suggested for lung cancer patients scheduled for lung resection. We describe different types of exercise testing techniques and present algorithms of preoperative evaluation in lung cancer patients. Overall, patients with maximal oxygen consumption (VO2max) <10 mL/kg/min or those with VO2max <15 mL/kg/min and both postoperative FEV1 and DLCO<40% predicted, are at high risk for perioperative death and postoperative cardiopulmonary complications, and thus should be offered an alternative medical treatment option.
2nd Pulmonary Clinic, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Anastasios
A
Kallianos
2nd Pulmonary Clinic, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Aggeliki
A
Rapti
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Sotirios
S
Tsimpoukis
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Andriani
A
Charpidou
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Ioannis
I
Dannos
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
Elias
E
Kainis
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece ksyrigos@med.uoa.gr.
Konstantinos
K
Syrigos
D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D005080:Exercise Test / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011300:Preoperative Care; D012129:Respiratory Function Tests
Lung resection; cardiopulmonary exercise testing; comorbidities; forced expiratory volume; non-small cell lung cancer; oxygen consumption; review