Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer

Nugent, A. M.; Steele, I. C.; Carragher, Angela M.; McManus, Kieran; McGuigan, Jim; Gibbons, Joseph; Riley, M.; Nicholls, D. P.

doi:10.1136/thx.54.4.334

Cited by 63 publications

(33 citation statements)

References 25 publications

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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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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

View full text Add to dashboard Cite

show abstract

“…Postoperative cardiopulmonary function and exercise capacity have been examined following pulmonary resection and demonstrated to be persistently decreased only after pneumonectomy (11,12). The impairment of respiratory function after a pneumonectomy may be explained by overdistention and emphysematous changes of the contralateral lung (which may show evidence of histological hyperplasia and loss of elasticity), an increase in the airway resistance resulting in alveolar gas mixing, arterial desaturation or late pulmonary failure.…”

Section: Discussionmentioning

confidence: 99%

Role of adjuvant chemotherapy after pneumonectomy for non-small cell lung cancer

Wang

Zhao

et al. 2012

Oncology Letters

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Abstract. Adjuvant chemotherapy is used as an alternative treatment for non-small cell lung cancer (NSCLC); however, the efficiency of post-pneumonectomy adjuvant chemotherapy in NSCLC has not been clarified. In the present study, patients who benefited from adjuvant chemotherapy with TP/NP/GP were identified. A total of 217 patients who underwent pneumonectomy were identified in this study. Of these, 87 underwent pneumonectomy combined with adjuvant chemotherapy (TP/NP/GP regimen) and 130 underwent pneumonectomy only in the initial management. The primary endpoint of the present study was overall survival. Actuarial survival analysis was conducted using the Kaplan-Meier method. Postoperative adjuvant chemotherapy significantly improved the survival rate of patients who underwent left pneumonectomy and in patients with a preoperative forced expiratory volume in 1 sec (FEV1) greater than or equal to 2 l. Age had no effect on the survival rate of patients with or without postoperative adjuvant therapy. Post-pneumonectomy adjuvant chemotherapy is an efficient therapy in NSCLC for patients with preoperative FEV1 greater than or equal to 2 l or who received left pneumonectomy.

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“…Patients who undergo surgical therapy for their lung cancer should not expect severe debilitation postoperatively. With appropriate preoperative evaluation and peri-and postoperative care, only patients who have undergone pneumonectomies can expect impaired exercise performance [9]. In a group of 77 patients who had surgical intervention for lung cancer, patients who had pneumonectomies had a decline in exercise capacity of 28% (maximal oxygen uptake declined 28%) [9].…”

Section: Treatmentmentioning

confidence: 99%

Cardiopulmonary rehabilitation after treatment for lung cancer

Nazarian

2004

Curr. Treat. Options in Oncol.

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Lung cancer is the leading cause of cancer-related death in women and men in the United States. As of 1987, lung cancer deaths in women exceeded deaths caused by breast cancer. Despite years of research and improvements in surgical, chemotherapeutic, and radiation treatments, this fact remains unchanged. Equally dismal is that the expected 5-year survival rate for all patients with lung cancer is 15%. Although hidden in this number is improved survival for many patients who have early disease, it still translates into significant morbidity and early mortality for many patients. Although prevention is key, optimizing the care of these patients with lung cancer is also paramount. Cardiopulmonary rehabilitation programs have been shown to be effective in treating patients with chronic heart and lung diseases, among other illnesses, regardless of prerehabilitation functioning. Not only do morbidity and mortality from cancer hinge directly on premorbid functioning, health, and status, but functional status as a measure of baseline health is a reliable prognostic indicator for patients with lung cancer. As a result, including a program of exercise in any treatment regimen for cancer is sensible. However, rehabilitation in patients with lung cancer has not been studied well. Data on rehabilitation in patients with other cancers and illnesses (eg, chronic obstructive pulmonary disease) are clear in the beneficial effects of supervised exercise on quality of life (QOL). To assess the role of cardiopulmonary rehabilitation in patients with lung cancer undergoing treatment, it is necessary to meld studies regarding patients with noncancerous conditions with studies addressing rehabilitation in patients with cancer. This fusion of information demonstrates that rehabilitation results in significant improvements in QOL in patients who participate, regardless of the disease in question. Although QOL may not always have been an obvious endpoint for treating patients with lung cancer, it is apparent from studies of the patients themselves that an improved QOL is far more important than other goals of therapy.

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Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer

Cited by 63 publications

References 25 publications

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

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

Role of adjuvant chemotherapy after pneumonectomy for non-small cell lung cancer

Cardiopulmonary rehabilitation after treatment for lung cancer

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