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Preoperative assessment for lung cancer surgery
Chris T Bolliger1, Coenraad F N Koegelenberg, Rosamund Kendal
1Respiratory Research Unit, Medical School, Faculty of Health Sciences Tygerberg Academic Hospital and University of Stellenbosch, Cape Town, South Africa. ctb@sun.ac.za
Current Opinion in Pulmonary Medicine
|June 2, 2005
Summary
Lung cancer surgery is advancing with new preoperative evaluations. Stair climbing is a simple test to assess patient fitness for lung cancer resection, potentially enabling surgery for more patients.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Oncology
Background:
- Pulmonary resection is the primary curative treatment for lung cancer.
- Preoperative evaluation is crucial for patient selection and surgical planning.
Purpose of the Study:
- To review recent advancements in the preoperative functional assessment of lung cancer patients.
- To highlight new surgical techniques and evaluation methods enabling surgery for previously inoperable individuals.
Main Methods:
- Review of current literature on lung cancer preoperative workup.
- Analysis of new diagnostic tools and surgical approaches.
- Evaluation of exercise testing, specifically stair climbing, as a predictor of cardiorespiratory reserve.
Main Results:
- Significant progress in assessing tumor extent and patient cardiopulmonary reserves.
- Segmentectomy is emerging as a viable option for early-stage lung cancers (Stage Ia, ≤20 mm).
- Early exercise testing, using stair climbing as a surrogate for maximal oxygen consumption, is gaining emphasis.
- Combined lung volume reduction surgery and lung cancer surgery can benefit select patients with poor lung function.
Conclusions:
- Advancements in preoperative assessment and surgical techniques are expanding surgical eligibility for lung cancer patients.
- A simplified algorithm incorporating stair climbing is proposed for preoperative evaluation.
- These developments aim to improve outcomes for patients with lung cancer by enabling necessary resections.