Cardiopulmonary Function at Rest and During Exercise After Resection for Bronchial Carcinoma

Larsen, Klaus; Svendsen, U. G.; Milman, Nils; Brenøe, Jørn; Petersen, B.

doi:10.1016/s0003-4975(97)00635-8

Cited by 79 publications

(53 citation statements)

References 20 publications

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“…Similar results had already been obtained by pulmonary static function tests and after exercise in lung cancer patients undergoing pulmonary resection [13,14].…”

Section: Discussionsupporting

confidence: 85%

Which factors affect pulmonary function after lung metastasectomy?☆

Petrella

Chieco²,

Solli

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Background: Pulmonary metastasectomy is an accepted procedure in selected patients, very often requiring multiple non-anatomical resections. Although it is intuitive that functional loss is proportional to the number and extent of pulmonary resections, this link has never been proved and is the hypothesis behind this study. Methods: We retrospectively reviewed pulmonary function changes after lung metastasectomy. Baseline and postoperative spirometric values were evaluated and their changes were correlated to (a) number of resections, (b) extent of resections and (c) intervals between surgery. Results: Sixty-six patients were enrolled (31 men, mean age 56 years, range: 23-75); mean interval between surgery: 54.5 days; mean extent of resection: 11.45 cm; mean number of resections: 3. Preoperative mean spirometric values were: FEV1 2.73 l (97.75%); FVC 3.11 l (95.50%); DLCO/AV 1.21 l (99.80%). Mean changes in FEV1, FCV and DLCO/AV were À13.4%, À12.4% and +1.2% respectively. Patients receiving three or more non-anatomical resections had functional loss similar to those undergoing lobectomy. The extent of total resection (>11 cm, p < 0.05) and the interval between surgery (>90 days, p < 0.0001) influenced FEV1 and FVC modifications. At three months none of these functional modifications remained. Sex, age, side of the operation and histology of primary tumor did not affect spirometric changes. Conclusions: Spirometric changes after pulmonary metastasectomy are affected by total volume lung parenchyma resected within the first 90 days. Functional loss after three or more non-anatomical resections is comparable to that recorded after lobectomy. #

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“…Similar results had already been obtained by pulmonary static function tests and after exercise in lung cancer patients undergoing pulmonary resection [13,14].…”

Section: Discussionsupporting

confidence: 85%

Which factors affect pulmonary function after lung metastasectomy?☆

Petrella

Chieco²,

Solli

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…The residual function (FEV1, DL,CO and VO 2 , peak) may reach values as high as 90-95% of preoperative values 3-6 months after operation. Conversely, after pneumonectomy, the loss in pulmonary function and exercise capacity is larger (20-30% at 6 months) and substantially stable over time [54,64,65,[192][193][194][195]. In general, exercise tolerance displays a more complete recovery compared to airflow and gas exchange capacities, presumably due to other compensatory mechanisms related to the cardiovascular system and the peripheral oxygen extraction capacity [54,64,194].…”

Section: Residual Function and Qol After Radical Treatmentmentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

750

550

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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“…13,16 -20 However, pulmonary function assessment alone has been a poor predictor of patients' perceptions of physical disruptions in day-to-day activities. [21][22] Because of the lack of data describing lung cancer survivors, the primary purpose of this study was descriptive in nature. The specific aims of this report are to describe, in long-term survivors of NSCLC, the following: (1) the frequency, severity, and clustering of respiratory symptoms (cough, phlegm, wheeze, and dyspnea) and characteristics of respiratory illnesses within the past year; (2) pulmonary function abnormalities (as measured by spirometry) and their relationship to symptoms; (3) the relationship of health status and disease/treatment variables to presence of respiratory symptoms; and (4) the relationship of respiratory symptoms and lung function findings to QOL.…”

mentioning

confidence: 99%

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

Sarna

Evangelista

Tashkin

et al. 2004

Chest

204

153

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Purpose: To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL). Methods: Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n ‫؍‬ 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36). Results: Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV 1 percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV 1 . Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains. Conclusions: The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer. (CHEST 2004; 125:439 -445)Key words: cancer survivors; chronic lung disease; lung neoplasms; pulmonary function; quality of life; respiratory symptoms; tobacco, smoking Abbreviations: ATS ϭ American Thoracic Society; df ϭ degrees of freedom; FEF 25-75% ϭ maximum expiratory flow rate; NSCLC ϭ non-small cell lung cancer; QOL ϭ quality of life; SF-36 ϭ Short Form-36 T he long-term consequences of the curative treatment for non-small cell lung cancer (NSCLC) on pulmonary status, the frequency of respiratory symptoms, and the impact of these pulmonary consequences on the quality of life (QOL) of such survivors have not been previously reported. Respiratory distress, even among the 14% of patients with NSCLC who are disease-free survivors, 1 may negatively affect QOL. Dyspnea and other respiratory symptoms have been reported to negatively impact QOL in those with COPD and other chronic lung conditions, 2-8 but little information is available about the impact on people with cancer. 9 One study 10 suggests that patients with NSCLC may actually have better QOL than those with severe COPD.*From the School of Nursing (Drs. Sarna and Evangelista),

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Cardiopulmonary Function at Rest and During Exercise After Resection for Bronchial Carcinoma

Cited by 79 publications

References 20 publications

Which factors affect pulmonary function after lung metastasectomy?☆

Which factors affect pulmonary function after lung metastasectomy?☆

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

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