Original article: general thoracicUse of Quantitative Lung Scintigraphy to Predict Postoperative Pulmonary Function in Lung Cancer Patients Undergoing Lobectomy
Section snippets
Patients
For more than 18 months, we prospectively performed full pulmonary function tests and quantitative planar V/Q scintigraphy on 61 (35 male and 26 female) consecutive patients undergoing lobectomy for non-small cell lung cancer. Their mean age was 69.2 years (range, 54 to 85). The mean body mass index was 26.5 (range, 17 to 38). All except 2 were ex or current smokers. Fifteen patients had borderline preoperative lung function (FEV1 less than 1.5 L). Lobectomy was performed by our institution's
Results
The results are summarized in Table 3, Table 4, Table 5, Table 6.
Predicted postoperative FEV1 was higher than 0.7 L in all patients with the lowest being 0.77 L using all methods. The lowest actual postoperative FEV1 was 0.5 L. In 7 patients, predicted postoperative percentage of predicted FEV1 (the predicted FEV1 corrected for height, sex, and age) was less than 40%, the lowest being 23%, using all three different techniques. The lowest observed postoperative percentage of predicted FEV1 was
Comment
For most patients with non-small cell lung cancer, surgery remains the best prospect for cure. The preoperative evaluation of patients with lung cancer is a challenging problem. The presence of carcinoma causes a decrease in both ventilation and perfusion of the involved lung, especially in hilar lesions. In order to define those patients with borderline pulmonary function who will benefit from lobectomy, many studies have tried to predict postoperative pulmonary function. Radionuclide lung
Acknowledgements
Dr Win received a National Health Service Eastern Region Research and Development Grant. We would like to thank Dr Linda Sharples (Medical Research Council, Biostatistician, Research and Development Unit, Papworth Hospital) for her statistical advice regarding this manuscript.
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