The impact of decreasing cutoff values for maximal oxygen consumption (vo2max) in the decision-making process for candidates to lung cancer surgery

摘要: Background: Maximal oxygen consumption (VO 2 max) is considered a decisive test for risk prediction in patients with borderline cardiopulmonary reserve. Guidelines have adopted decreasing VO2max cut-off values to define operability within acceptable mortality and morbidity limits. We wanted investigate how the adoption of cut-off-values assessment contributed better select lung surgery candidates. Methods: One hundred nineteen consecutive surgical candidates been prospectively analyzed as sample population. Preoperative work-up included spirometry transfer factor (DLco); irrespective spirometric values, these were subjected assessment. Surgical eligibility was decided by same surgeon throughout series. In postoperative period, overall occurrence any, major or minor complications recorded graded according Common Terminology Criteria Adverse Events v.4.3. Results: Three arbitrary cut-offs introduced at 15, 14 12 mL.kg-1.min-1. Notably, 15 mL.kg-1.min-1 correlated percentage 50% 35% predicted (P (P=0.0457) emerged significant predictors survival after surgery. Conversely on logistic regression analysis, age over 70 years (P=0.03) pneumonectomy (P=0.001), but not (CTCAE >2) morbidity. Conclusions: Since increasingly used contribute individual patient, surgeons need be advised that concept definitive, generalized value probably contradiction terms. Patient-specific are more likely since they may reflect primarily affected component among determinants maximal consumption. Whether patient-specific should routinely needs further evaluation.