title: Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer.
abstract: Pulmonary function tests predict respiratory complications after lobectomy. We evaluated the impact of pulmonary function measurements on long-term survival after lobectomy for stage I non-small cell lung cancer.
  
  
  
  The relationship between percent predicted forced expiratory volume in 1 second (FEV1) and percent predicted diffusing capacity of the lung for carbon monoxide (Dlco) and overall survival for patients who underwent lobectomy without induction therapy for stage I (T1-2N0M0) non-small cell lung cancer from 1996 to 2012 was evaluated using the Kaplan-Meier approach and a multivariable Cox proportional hazard model.
  
  
  
  During the study period, 972 patients (mean Dlco 76 ± 21, mean FEV1 73 ± 21) met inclusion criteria. Perioperative mortality was 2.6% (n = 25). The 5-year survival of the entire cohort was 60.1%, with a median follow-up of 43 months. The 5-year survival for patients with percent predicted FEV1 stratified by more than 80%, 61% to 80%, 41% to 60%, and 40% or less was 70.1%, 59.3%, 52.5%, and 53.4%, respectively. The 5-year survival for patients with percent predicted Dlco stratified by more than 80%, 61% to 80%, 41% to 60%, and 40% or less was 70.2%, 63.4%, 44.2%, and 33.1%, respectively. In multivariable survival analysis, both larger tumor size (hazard ratio 1.15, p = 0.01) and lower Dlco (hazard ratio 0.986, p < 0.0001) were significant predictors of worse survival. The association of FEV1 and survival was not statistically significant (p = 0.18).
  
  
  
  Survival after lobectomy for patients with stage I non-small cell lung cancer is impacted by lower Dlco, which can be used in the risk and benefit assessment when choosing therapy.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina; Department of Cardiothoracic Surgery, Stanford University, Stanford, California. Electronic address: berry037@stanford.edu.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Berry
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Chi-Fu Jeffrey
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Hartwig
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Betty C
authors.initials: BC
authors.lastname: Tong
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: David H
authors.initials: DH
authors.lastname: Harpole
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: D'Amico
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Onaitis
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D011653:Pulmonary Diffusing Capacity; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors