title: Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC.
abstract: Thoracic surgery remains the better therapeutic option for non-small cell lung cancer patients that are diagnosed in early stage disease. Preoperative lung function assessment includes respiratory function tests (RFT) and cardio-pulmonary exercise testing (CPET). Vo2 peak, FEV1 and DLCO as well as recognition of performance status, presence of co-morbidities, frailty indexes, and age predict the potential impact of surgical resection on patient health status and survival risk. In this study we have retrospectively assessed the benefit of a high-intensity preoperative pulmonary rehabilitation program (PRP) in 14 patients with underlying lung function impairment prior to surgery. Amongst these, three patients candidate to surgical resection exhibited severe functional impairment associated with high score of frailty according CHS and SOF index, resulting in a substantial mortality risk. Our observations indicate that PRP appear to reduce the mortality and morbidity risk in frail patients with concurrent lung function impairment undergoing thoracic surgery. PRP produced improvement of VO2 peak degree and pulmonary function resulting in reduced postoperative complications in high-risk patients from our cases. Our results indicate that a preoperative training program may improve postoperative clinical outcomes in fraillung cancer patients with impaired lung function prior to surgical resection.
authors.affiliation: Unit of Thoracic Surgery, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Salvi
authors.affiliation: Unit of Pneumology, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Ilernando
authors.initials: I
authors.lastname: Meoli
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cennamo
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Perrotta
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Saverio Cerqua
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Montesano
authors.affiliation: Unit of Thoracic Surgery, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Curcio
authors.affiliation: Unit of Radiology, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lassandro
authors.affiliation: Unit of Pneumology, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Stefanelli
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Grella
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Mazzarella
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy Phone:+390815665228, , E-mail: andrea_bianco_1962@yahoo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bianco
keywords: Aging; Frail patients; Non-small cell lung cancer; Pulmonary rehabilitation program; Respiratory function tests; Thoracic Surgery