Abstract
AIM: analyse the clinical and functional results during the first year of application of the ERS/ESTS guidelines on fitness for radical therapy in lung cancer (LC) patients.
Methods: prospective analysis of data of those patients proposed to surgical treatment for LC. We analysed pre FEV1, DLCO, VO2%, VO2/kg/min , complications in the first 30 days, mortality at 6 months and six months postFEV1, DLCO, VO2%, VO2/kg/min when available.
Results: during 2013,103 patients were proposed to surgical treatment because of LC .All of them were evaluated with FEV1 and DLCO. Of them, 52 needed a CPET (ERS/ESTS guidelines: FEV1 or DLCO<80%), in 30 patients due to FEV1<80, in 46 due to DLCO<80 and in 24 due to both factors.Using the previous protocol (ppoFEV1 or ppoDLCO<40%) we should use it in only 13 patients. The main functional data were: FEV1 78%(33-113), DLCO 64%(39-106), VO2% 92,4 (63-119), VO2/kg/min 21.6. Five cases were contraindicated for surgery and another patient refused intervention. Of these five, two cases shouldn´t be contraindicated with previous protocol.
8 complications were registered in first 30 days, three of them moderate. 2 deaths in six months not related to surgery were found.
In 12 patients we made a second CPET six months after surgery. Only VO2/kg/min showed a significant difference (p=0.02)
Conclusions:
-We could apply ERS/ESTS guideline to 100% of our patients
-The main cause of CPET indication was impaired DLCO
-Half of cases proposed for surgery needed CPET, much more than those if we use previous protocol
-we only found deterioration in VO2/k/min but our sample is still small.
- © 2014 ERS
