[Cardiorespiratory limits to the surgical treatment of lung cancer]

Cardiorespiratory co-morbidity is a predictive factor of post-surgical mortality and morbidity. In the case of lung cancer, the pre-therapeutic work-up must assess the post-surgical risks by integrating such co-morbidity. In view of this, predictive scores and decisional algorithms have been developed. However, such tools were developed and assessed only to predict post-surgical risks during the first or second month following resection. Till now, prediction of long term quality of candidates for pulmonary resection has not be studied, although the question has often been raised by the patient and the medical and surgical teams, notably in the case of cardiorespiratory limitation prior to the intervention. A study on the predictability of the quality of life at 6 months following pulmonary resection was conducted in the Tenon hospital in a cohort of 81 patients, candidates for resection, initially selected on an MMFR lesser than 80% of the reference. Out of the 43 patients who finally underwent resection and were analysed at 6 months, there were few predictive factors for the alteration in quality of life at 6 months following pulmonary resection, other than the extension of the surgical act. Conversely, this alteration did not significantly depend on the immediate post-surgical events and can be explained by the deterioration in respiratory function.