PT - JOURNAL ARTICLE AU - T. Win AU - A. Jackson AU - L. Sharples AU - A. M. Groves AU - F. C. Wells AU - A. J. Ritchie AU - C. M. Laroche TI - Relationship between pulmonary function and lung cancer surgical outcome AID - 10.1183/09031936.05.00077504 DP - 2005 Apr 01 TA - European Respiratory Journal PG - 594--599 VI - 25 IP - 4 4099 - http://erj.ersjournals.com/content/25/4/594.short 4100 - http://erj.ersjournals.com/content/25/4/594.full SO - Eur Respir J2005 Apr 01; 25 AB - The British Thoracic Society and American College of Chest Physician guidelines outline criteria for investigating patients for lung cancer surgery. However, the guidelines are based on relatively old studies. Therefore, the relationship between pulmonary function test results and surgical outcome were studied prospectively in a large cohort of lung cancer patients. From January 2001 to December 2003, 110 patients underwent surgery for lung cancer. All underwent full lung function testing in order to predict post-operative lung function. The hospital mortality rate was 3% and major complication rate 22%. There was poor overall outcome in 13%. Mean pre-operative lung function values were: forced expiratory volume in one second (FEV1) 2.0 L (79.4% of the predicted value), and carbon monoxide diffusing capacity of the lung (DL,CO) 73.6% pred. The mean post-operative lung function values were: FEV1 1.4 L (55.6% pred), and DL,CO 51.3% pred. All lung function values were better predictors of poor surgical outcome when expressed as a percentage of the predicted value. Using a threshold of pre-operative FEV1 of 47% pred resulted in the most useful positive and negative predictive probabilities, 0.90 and 0.67, respectively. Lung function values expressed as a percentage of the predicted value are more useful predictors of post-operative outcome than absolute values. The threshold of predicted forced expiratory volume in one second for surgical intervention could be lower (45–50% pred) than is currently accepted without increased mortality.