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Preoperative evaluation for lung cancer resection.

Dionysios Spyratos1, Paul Zarogoulidis1, Konstantinos Porpodis1

  • 11 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 5 Department of Cardiac Surgery, University of Ioannina, School of Medicine, Greece ; 6 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 7 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 8 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 9 Anesthisiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 10 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece.

Journal of Thoracic Disease
|March 28, 2014
PubMed
Summary

Lung cancer remains a leading global cause of death. This review discusses preoperative evaluation strategies for lung cancer patients, considering comorbidities and screening challenges.

Keywords:
Lung cancerpreoperativesurgery

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Area of Science:

  • Oncology
  • Pulmonology
  • Public Health

Background:

  • Lung cancer is a leading cause of cancer death globally, with smoking as a primary risk factor.
  • Other environmental and occupational exposures, including asbestos, heavy metals, radon, and air pollution, also contribute to lung cancer development.
  • Despite reduced mortality in heavy smokers via screening programs, widespread clinical implementation and cost-effectiveness remain challenging.

Purpose of the Study:

  • To review and comment on the preoperative evaluation of lung cancer patients.
  • To highlight the complexities in surgical candidate selection due to comorbidities and low resection rates.
  • To discuss existing clinical guidelines for preoperative assessment.

Main Methods:

  • Review of published clinical guidelines from major thoracic associations.
  • Analysis of factors influencing surgical resection rates in lung cancer.
  • Commentary on the challenges of preoperative assessment in clinical practice.

Main Results:

  • Surgical resection rates for lung cancer remain low (20-30%) due to factors like smoking-related comorbidities (e.g., COPD, coronary heart disease).
  • Multiple clinical guidelines exist for preoperative assessment, offering detailed algorithms.
  • The cost-effectiveness and practical implementation of lung cancer screening programs require further investigation.

Conclusions:

  • Preoperative evaluation for lung cancer is complex, influenced by patient comorbidities and the need for effective screening strategies.
  • Existing guidelines provide a framework for assessment, but challenges persist in clinical practice.
  • Further research is needed on the cost-effectiveness and integration of screening and preoperative assessment protocols.