Does lobectomy for lung cancer in patients with chronic obstructive pulmonary disease affect lung function? A multicenter national study

Sergio Baldi, Enrico Ruffini, Sergio Harari, Gian Carlo Roviaro, Mario Nosotti, Nadia Bellaviti, Federico Venuta, Daniele Diso, Federico Rea, Claudio Schiraldi, Alberto Durigato, Maurizio Pavanello, Angelo Carretta, Piero Zannini

Research output: Contribution to journalArticle

Abstract

Objective: The purpose of this study was to evaluate the effect of lobectomy on pulmonary function in patients with chronic obstructive pulmonary disease. Methods: One hundred thirty-seven patients were analyzed; 49 had normal pulmonary function tests, and 88 had chronic obstructive pulmonary disease. Different functional parameter groups were identified: obstructive (forced expiratory volume in 1 second [FEV 1], forced expiratory volume in 1 second/forced vital capacity [FEV 1/FVC], and chronic obstructive pulmonary disease index), hyperinflation (residual volume and functional residual capacity), and diffusion (transfer factor of the lung for carbon monoxide). Also, the ratio between observed and predicted postoperative FEV 1 was calculated. Results: In patients with preoperative FEV 1 greater than 80% of predicted, postoperative FEV 1/FVC slightly but not significantly decreased, and postoperative FEV 1 significantly decreased. In patients with preoperative FEV 1 less than 65%, postoperative FEV 1 and FEV 1/FVC significantly increased. In patients with preoperative FEV 1/FVC greater than 70%, postoperative FEV 1 and FEV 1/FVC significantly decreased. In patients with preoperative FEV 1/FVC less than 70%, postoperative FEV 1/FVC increased, and FEV 1 remained unchanged. In patients with a chronic obstructive pulmonary disease index greater than 1.5, postoperative FEV 1 and FEV 1/FVC significantly decreased, whereas in patients with a chronic obstructive pulmonary disease index less than 1.5, postoperative FEV 1/FVC significantly increased and FEV 1 remained unchanged. In patients with residual volume and functional residual capacity greater than 115% and transfer factor of the lung for carbon monoxide less than 80% of predicted, postoperative FEV 1 diminished less (not significant) compared with patients who had residual volume and functional residual capacity less than 115% (P = .0001). Observed postoperative/predicted postoperative FEV 1 was higher if FEV 1/FVC was less than 55% (1.46), if FEV 1 was less than 80% of predicted (1.21), or if the chronic obstructive pulmonary disease index was less than 1.5 (1.17). Conclusions: Patients with mild to severe chronic obstructive pulmonary disease could have a better late preservation of pulmonary function after lobectomy than healthy patients.

Original languageEnglish
Pages (from-to)1616-1622
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume130
Issue number6
DOIs
Publication statusPublished - Dec 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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  • Cite this

    Baldi, S., Ruffini, E., Harari, S., Roviaro, G. C., Nosotti, M., Bellaviti, N., Venuta, F., Diso, D., Rea, F., Schiraldi, C., Durigato, A., Pavanello, M., Carretta, A., & Zannini, P. (2005). Does lobectomy for lung cancer in patients with chronic obstructive pulmonary disease affect lung function? A multicenter national study. Journal of Thoracic and Cardiovascular Surgery, 130(6), 1616-1622. https://doi.org/10.1016/j.jtcvs.2005.06.049