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Lung Neoplasms

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Lung Neoplasms

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Lung Neoplasms

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LUNG NEOPLASMS

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Surgical resection is the most effective method of controlling the local disease in patients with non small cell lung cancer (NSCLC) and is the most effective treatment consistently associated with cure in non-metastatic cancer.
Morbidity and mortality rates after lung resection for carcinoma have greatly reduced over the past years, due not only to developments in diagnostic, operative and anesthetic techniques, but also to improvements in perioperative management, particularly in the field of functional therapy, as well as better patient selection after more rigorous staging.
Curative surgery is unfortunately only applicable to a small percentage (20%) of patients with NSCLC (16, 21, 26). One reason for this is the usually advanced stage of the disease process at time of diagnosis. Another reason is that a number of patients are denied surgery because of age, cardiovascular disease, limited pulmonary function, or other comorbid affections. Among this “high risk” population are some patients with potentially resectable cancer, but who are thought to be unable to tolerate major lung resection because of their general of respiratory status.
Determinants to identify patients who are unable to safety undergo major lung resection remain controversial. Some authors have reported increased morbidity and mortality rates when the preoperative FAV1 was less than 40% of predicted normal values (2, 5, 8), or when preoperative DLCO was less than 50% of predicted values (19, 20).
Recent studies, however, seem to suggest that some patients with lung cancer and poor respiratory function could safety undergo major pulmonary resection if selected properly, and especially, if careful pre and perioperative management is instituted. By this approach, many authors have reported good results in patients who would otherwise have been refused operation (9, 42).
This study was undertaken with, as objective the assessment of the reciprocal effects of poor respiratory function and lung resection surgery for NSCLC. Our goal is to determine whether patients with NSCLC and poor respiratory function could benefit from curative lung resection

Lung Neoplasms --- Lung neoplasms --- Mortality