The role of peak oxygen consumption measurement in predicting postoperative pulmonary complications in patients with early stage lung cancer

Abstract

Introduction: The best survival rates are achieved in early stage lung cancer patients who had undergone surgical resection. Cardiopulmonary Exercise Testing (CPET) is an important preoperative test because of its ability to detect disturbance in oxygen transport system which inturn is related to development of postoperative complications. The aim of this study is to identify the value of peak oxygen consumption (peakVO2) measurement in predicting postoperative pulmonary complications (PPCs).

Methods: Lung cancer patients who are candidates for surgery between Feb 2015- Feb 2017 were included in this propectively conducted study. PeakVO2 measurement was performed by utilizing cycle ergometry with the current system ""Fitmate®Med"" during incremental exercise. All patients were on follow-up for PPCs for a period of 30 days postoperatively.

Results: The study included 41 patients (mean age:63.9±9.7 years) who had undergone surgical resection (28 lobectomy/13 pneumonectomy) in our hospital. There was no mortality; but 8 (19.5%) PPCs. Mean peakVO2 value wasn't different in patients with and without PPCs. When the patients were divided into two groups based on absolute FEV1 (≤1.5 L and >1.5 L) and ppoFEV1% (≤%30 and >%30), mean peakVO2, mean staying days in intensive care and hospital, PPC rates were similar between groups. 14 patients who had a FEV1 ≤1.5 L; 11 patients who had a ppoFEV1 ≤%30 underwent successful surgical resections.

Conclusion: PeakVO2 measurement prevents patients to be deprived of a surgical resection that is an important treatment modality for lung cancer. PPCs were in acceptable limits in patients with adequate peakVO2 values.