Preoperative maximum oxygen consumption is associated with prognosis after pulmonary resection in stage I non-small cell lung cancer.

Autor:	Brunelli A; Department of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom. Electronic address: brunellialex@gmail.com., Pompili C; Division of Thoracic Surgery, Ospedali Riuniti, Ancona, Italy., Salati M; Division of Thoracic Surgery, Ospedali Riuniti, Ancona, Italy., Refai M; Division of Thoracic Surgery, Ospedali Riuniti, Ancona, Italy., Berardi R; Department of Medical Oncology, Ospedali Riuniti, Ancona, Italy., Mazzanti P; Department of Medical Oncology, Ospedali Riuniti, Ancona, Italy., Tiberi M; Department of Medical Oncology, Ospedali Riuniti, Ancona, Italy.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2014 Jul; Vol. 98 (1), pp. 238-42. Date of Electronic Publication: 2014 May 27.
DOI:	10.1016/j.athoracsur.2014.04.029
Abstrakt:	Background: The objective of this investigation was to evaluate whether maximum oxygen consumption (VO2max) is a reliable prognostic factor after lung resection for pathologic stage I non-small cell lung cancer (NSCLC). Methods: Observational analysis of 157 patients undergoing pulmonary lobectomy or segmentectomy for pathologic stage I (T1 or T2-N0 only) NSCLC, with preoperative measurement of Vo2max and complete follow-up (2006-2011). Survival was calculated by the Kaplan-Meier method. The log-rank test was used to assess differences in survival between groups. The relationships between survival and several baseline and clinical variables were determined by Cox multivariate analyses. Results: The median follow-up time was 40 months. The average preoperative Vo2max was 16.1 mL/kg · min and 69% of predicted value. Sixty-two (40%) patients had a Vo2max below 60%. The median and 5-year overall survivals of patients with preoperative Vo2max above 60% were significantly longer than in those with Vo2max below 60% (median not reached vs 48 months: 73% vs 40%, p=0.0004). Cox regression model showed that an age older than 70 years (p=0.005, hazard ratio 2.3) and Vo2max below 60% (p=0.001, hazard ratio 2.4) were independent prognostic factors significantly associated with overall survival. Cancer-specific survival was also longer in patients with Vo2max above 60% (81% vs 61%, p=0.01). Conclusions: Exercise tolerance may influence the physiologic outcomes associated with cancer that can potentially affect survival. Physical rehabilitation aimed at improving exercise tolerance can possibly improve the long-term prognosis after operations for lung cancer. (Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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