Resection of lung cancer is justified in high-risk patients selected by exercise oxygen consumption

摘要: Abstract The medical criteria for inoperability have been difficult to define in patients with lung cancer. Sixty-six non-small cell cancer and radiographically resectable lesions were evaluated prospectively a clinical trial. considered by cardiac or pulmonary be high risk resection. If exercise testing revealed peak oxygen uptake of 15 mL · kg −1 min greater, the patient was offered surgical treatment. Of 20 procedures performed, nine lobectomies, two bilobectomies, wedge segmental resections. All extubated within 24 hours discharged 22 days after operation (median time discharge, 8 days). There no deaths, complications occurred (40%) patients. Five whose lower than also underwent intervention; there one death. Thirty-four less 7 who declined radiation therapy alone (35 patients) chemotherapy (6 patients). treatment-related morbidity rate 12% ( 5 / 41 ). median duration survival 48 ± 4.3 months treated surgically 17 2.7 those medically ( p = 0.0014). We conclude that subgroup would inoperable disease traditional can selected on basis consumption testing. is striking benefit an aggressive approach these