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Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer.

Publication ,  Journal Article
Berry, MF; Yang, C-FJ; Hartwig, MG; Tong, BC; Harpole, DH; D'Amico, TA; Onaitis, MW
Published in: Ann Thorac Surg
July 2015

BACKGROUND: Pulmonary function tests predict respiratory complications after lobectomy. We evaluated the impact of pulmonary function measurements on long-term survival after lobectomy for stage I non-small cell lung cancer. METHODS: The relationship between percent predicted forced expiratory volume in 1 second (FEV1) and percent predicted diffusing capacity of the lung for carbon monoxide (Dlco) and overall survival for patients who underwent lobectomy without induction therapy for stage I (T1-2N0M0) non-small cell lung cancer from 1996 to 2012 was evaluated using the Kaplan-Meier approach and a multivariable Cox proportional hazard model. RESULTS: During the study period, 972 patients (mean Dlco 76 ± 21, mean FEV1 73 ± 21) met inclusion criteria. Perioperative mortality was 2.6% (n = 25). The 5-year survival of the entire cohort was 60.1%, with a median follow-up of 43 months. The 5-year survival for patients with percent predicted FEV1 stratified by more than 80%, 61% to 80%, 41% to 60%, and 40% or less was 70.1%, 59.3%, 52.5%, and 53.4%, respectively. The 5-year survival for patients with percent predicted Dlco stratified by more than 80%, 61% to 80%, 41% to 60%, and 40% or less was 70.2%, 63.4%, 44.2%, and 33.1%, respectively. In multivariable survival analysis, both larger tumor size (hazard ratio 1.15, p = 0.01) and lower Dlco (hazard ratio 0.986, p < 0.0001) were significant predictors of worse survival. The association of FEV1 and survival was not statistically significant (p = 0.18). CONCLUSIONS: Survival after lobectomy for patients with stage I non-small cell lung cancer is impacted by lower Dlco, which can be used in the risk and benefit assessment when choosing therapy.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2015

Volume

100

Issue

1

Start / End Page

271 / 276

Location

Netherlands

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Diffusing Capacity
  • Prognosis
  • Predictive Value of Tests
  • Pneumonectomy
  • Neoplasm Staging
  • Male
 

Citation

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Berry, M. F., Yang, C.-F., Hartwig, M. G., Tong, B. C., Harpole, D. H., D’Amico, T. A., & Onaitis, M. W. (2015). Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg, 100(1), 271–276. https://doi.org/10.1016/j.athoracsur.2015.02.076
Berry, Mark F., Chi-Fu Jeffrey Yang, Matthew G. Hartwig, Betty C. Tong, David H. Harpole, Thomas A. D’Amico, and Mark W. Onaitis. “Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer.Ann Thorac Surg 100, no. 1 (July 2015): 271–76. https://doi.org/10.1016/j.athoracsur.2015.02.076.
Berry MF, Yang C-FJ, Hartwig MG, Tong BC, Harpole DH, D’Amico TA, et al. Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg. 2015 Jul;100(1):271–6.
Berry, Mark F., et al. “Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer.Ann Thorac Surg, vol. 100, no. 1, July 2015, pp. 271–76. Pubmed, doi:10.1016/j.athoracsur.2015.02.076.
Berry MF, Yang C-FJ, Hartwig MG, Tong BC, Harpole DH, D’Amico TA, Onaitis MW. Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg. 2015 Jul;100(1):271–276.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2015

Volume

100

Issue

1

Start / End Page

271 / 276

Location

Netherlands

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Diffusing Capacity
  • Prognosis
  • Predictive Value of Tests
  • Pneumonectomy
  • Neoplasm Staging
  • Male