Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection.

Area of Science:

• Cardiology
• Pulmonology
• Thoracic Surgery

Background:

• Lung resection offers curative potential for non-small cell lung cancer (NSCLC).
• Cardiovascular and lung comorbidities increase postoperative risks in NSCLC patients.
• Preoperative assessment is crucial for identifying patients at high risk of complications.

Purpose of the Study:

• To review the role of cardiopulmonary exercise testing (CPET) in preoperative evaluation for lung cancer patients undergoing resection.
• To present algorithms for preoperative assessment in this patient population.

Main Methods:

• Discussion of various exercise testing techniques.
• Review of existing literature on preoperative testing for lung cancer surgery.
• Presentation of risk stratification algorithms based on CPET parameters.

Main Results:

• Maximal oxygen consumption (VO2max) <10 mL/kg/min indicates high risk.
• VO2max <15 mL/kg/min combined with postoperative FEV1 and DLCO <40% predicted also signifies high risk.
• These high-risk indicators predict perioperative death and cardiopulmonary complications.

Conclusions:

• CPET is a valuable tool for risk stratification in lung cancer surgery candidates.
• Patients identified as high-risk should be considered for alternative treatment options.
• Optimizing preoperative assessment can improve patient outcomes and reduce mortality.