Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
World Journal of Surgery
Erschienen in:

10.01.2022 | Original Scientific Report

Risk Assessment for Loss-of-Exercise Capacity After Lung Cancer Surgery: Current Advances in Surgery and Systemic Treatment

verfasst von: Naoki Ozeki, Yuka Kadomatsu, Yota Mizuno, Takayuki Inoue, Motoki Nagaya, Masaki Goto, Shota Nakamura, Koichi Fukumoto, Toyofumi Fengshi Chen-Yoshikawa

Erschienen in: World Journal of Surgery | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Considering advances in current post-recurrence treatment, we examined the prognostic significance of the number of risk factors for loss-of-exercise capacity (LEC) after lung cancer surgery, which were identified by our previous prospective observational study.

Methods

Risk factors for LEC were defined as a short baseline 6-min walk distance (<400 m), older age (≥75 years), and low predicted postoperative diffusing capacity for carbon monoxide (<60%). Patients were classified as Risk 0/I/II/III according to the number of risk factors. The survival data were retrospectively analyzed.

Results

Between 2014 and 2017, 564 patients (n = 307, 193, 57, 7; Risk 0/I/II/III) who underwent lung cancer surgery were included in the study. The number of risk factors was associated with smoking status, predicted postoperative forced expiratory volume in 1 s, histology, pathological stage, and adjuvant therapy. In a multivariate Cox regression analysis, compared to Risk 0, Risk I/II/III showed significant associations with overall survival (hazard ratios: 1.92, 3.35, 9.21; 95% confidence interval: 1.27–2.92, 2.01–5.58, 3.64–23.35; Risk I/II/III, respectively). In 141 patients with recurrence, molecular targeted therapies (MTTs) or immune checkpoint inhibitors (ICIs) were included in 58%, 47%, 32%, and 0% (Risk 0/I/II/III) during the course of treatment. In patients with MTT/ICI treatment, the estimated 1-year and 3-year post-recurrence survival rates were 88% and 58%, respectively.

Conclusions

Risk classification for LEC was associated with survival after lung cancer surgery, as well as post-recurrence treatment. The concept of physical performance-preserving surgery may contribute to improving the outcomes of current lung cancer treatment.
Literatur
1.
Howington JA, Blum MG, Chang AC et al (2013) Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e278S–e313SCrossRef
2.
Rivera MP, Mehta AC, Wahidi MM (2013) Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e142S–e165SCrossRef
3.
Ozeki N, Iwano S, Taniguchi T et al (2014) Therapeutic surgery without a definitive diagnosis can be an option in selected patients with suspected lung cancer. Interact Cardiovasc Thorac Surg 19:830–837CrossRef
4.
Chen-Yoshikawa TF, Fukui T, Nakamura S et al (2020) Current trends in thoracic surgery. Nagoya J Med Sci 82:161–174PubMedPubMedCentral
5.
Gonzalez-Rivas D (2016) Uniportal thoracoscopic surgery: from medical thoracoscopy to non-intubated uniportal video-assisted major pulmonary resections. Ann Cardiothorac Surg 5:85–91CrossRef
6.
Feczko AF, Wang H, Nishimura K et al (2019) Proficiency of robotic lobectomy based on prior surgical technique in the society of thoracic surgeons general thoracic database. Ann Thorac Surg 108:1013–1020CrossRef
7.
Suzuki K, Saji H, Aokage K et al (2019) Comparison of pulmonary segmentectomy and lobectomy: safety results of a randomized trial. J Thorac Cardiovasc Surg 158:895–907CrossRef
8.
Kobayashi Y, Mitsudomi T (2016) Not all epidermal growth factor receptor mutations in lung cancer are created equal: perspectives for individualized treatment strategy. Cancer Sci 107:1179–1186CrossRef
9.
Suresh K, Naidoo J, Lin CT, Danoff S (2018) Immune checkpoint immunotherapy for non-small cell lung cancer: benefits and pulmonary toxicities. Chest 154:1416–1423CrossRef
10.
Wu YL, Tsuboi M, He J et al (2020) Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med 383:1711–1723CrossRef
11.
Brunelli A, Kim AW, Berger KI et al (2013) Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physiciansevidence-based clinical practice guidelines. Chest 143:e166S-e190SCrossRef
12.
Brunelli A, Charloux A, Bolliger CT et al (2009) ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J 34:17–41CrossRef
13.
Brunelli A, Pompili C, Salati M et al (2014) Preoperative maximum oxygen consumption is associated with prognosis after pulmonary resection in stage I non-small cell lung cancer. Ann Thorac Surg 98:238–242CrossRef
14.
Ozeki N, Fukui T, Kawaguchi K et al (2018) A survival analysis using physique-adjusted tumor size of non-small cell lung cancer. Int J Clin Oncol 23:266–274CrossRef
15.
Tanaka S, Ozeki N, Mizuno Y et al (2021) Preoperative paraspinous muscle sarcopenia and physical performance as prognostic indicators in non-small-cell lung cancer. J Cachexia Sarcopenia Muscle 12:646–656CrossRef
16.
Ozeki N, Fukui T, Iwano S et al (2021) Factors associated with changes in the 12-m stair-climbing time after lung lobectomy. Gen Thorac Cardiovasc Surg 69:282–289CrossRef
17.
Yılmaz E, Özalevli S, Ersöz H et al (2013) Comparison of health-related quality of life and exercise capacity according to stages in patients with non-small cell lung cancer. Tuberk Toraks 61:131–139CrossRef
18.
Kushibe K, Kawaguchi T, Kimura M et al (2008) Changes in ventilatory capacity, exercise capacity, and pulmonary blood flow after lobectomy in patients with lung cancer–which lobectomy has the most loss in exercise capacity? Interact Cardiovasc Thorac Surg 7:1011–1014CrossRef
19.
Salati M, Brunelli A, Xiumè F et al (2017) Video-assisted thoracic surgery lobectomy does not offer any functional recovery advantage in comparison to the open approach 3 months after the operation: a case matched analysis†. Eur J Cardiothorac Surg 51:1177–1182CrossRef
20.
Bade BC, Thomas DD, Scott JB et al (2015) Increasing physical activity and exercise in lung cancer: reviewing safety, benefits, and application. J Thorac Oncol 10:861–871CrossRef
21.
Spruit MA, Singh SJ, Garvey C et al (2013) An official American thoracic society/European respiratory society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 188:e13-64CrossRef
22.
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. (2002) ATS statement: guidelines for the 6-min walk test. Am J Respir Crit Care Med 166:111–117.
23.
Morley JE, Abbatecola AM, Argiles JM et al (2011) Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc 12:403–409CrossRef
24.
Lee H, Kim HK, Kang D et al (2020) Prognostic value of 6-min walk test to predict postoperative cardiopulmonary complications in patients with non-small cell lung cancer. Chest 157:1665–1673CrossRef
25.
Wesolowski S, Orlowski TM, Kram M (2020) The 6-min walk test in the functional evaluation of patients with lung cancer qualified for lobectomy. Interact Cardiovasc Thorac Surg 30:559–564CrossRef
26.
Brierley JD, Gospodarowicz MK, Wittekind C (2016) TNM classification of malignant tumours, 8th edn. Wiley-Blackwell, New York
27.
Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG (2015) WHO classification of tumours of the lung, pleura, thymus and heart. IARC Press, Lyon
28.
Ozeki N, Fukui T, Taniguchi T, Usami N, Kawaguchi K, Ito S, Sakao Y, Mitsudomi T, Hirakawa A, Yokoi K (2014) Significance of the serum carcinoembryonic antigen level during the follow-up of patients with completely resected non-small-cell lung cancer. Eur J Cardiothorac Surg 45:687–692CrossRef
29.
Ferguson MK, Watson S, Johnson E, Vigneswaran WT (2014) Predicted postoperative lung function is associated with all-cause long-term mortality after major lung resection for cancer. Eur J Cardiothorac Surg 45:660–664CrossRef
30.
Ozeki N, Kawaguchi K, Fukui T, Fukumoto K, Nakamura S, Hakiri S, Kato T, Hirakawa A, Okasaka T, Yokoi K (2017) The diffusing capacity of the lung for carbon monoxide is associated with the histopathological aggressiveness of lung adenocarcinoma. Eur J Cardiothorac Surg 52:969–974CrossRef
31.
Licker M, Karenovics W, Diaper J et al (2017) Short-term preoperative high-intensity interval training in patients awaiting lung cancer surgery: a randomized controlled trial. J Thorac Oncol. 12:323–333CrossRef
Metadaten
Titel
Risk Assessment for Loss-of-Exercise Capacity After Lung Cancer Surgery: Current Advances in Surgery and Systemic Treatment
verfasst von
Naoki Ozeki
Yuka Kadomatsu
Yota Mizuno
Takayuki Inoue
Motoki Nagaya
Masaki Goto
Shota Nakamura
Koichi Fukumoto
Toyofumi Fengshi Chen-Yoshikawa
Publikationsdatum
10.01.2022
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 4/2022
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-06427-3

Weitere Artikel der Ausgabe 4/2022

Societal Preferences for Gender of Surgeons: A Cross-Sectional Study in the General Population of Pakistan

  • Surgery in Low and Middle Income Countries

Inspirational Women in Surgery: Olga Jonasson, the Legacy of the First Female Chair of an Academic Department of Surgery

  • Editorial Perspective

Roux-en-Y Versus One Anastomosis Gastric Bypass as Redo-Operations Following Sleeve Gastrectomy: A Retrospective Study

  • Original Scientific Report

Relationship Between Prehospital Time and 24-h Mortality in Road Traffic-Injured Patients in Laos

  • Open Access
  • Original Scientific Report

Periumbilical Transverse Incision for Reducing Incisional Hernia in Laparoscopic Colon Cancer Surgery

  • Original Scientific Report

Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density and Bone Turnover Markers: A Systematic Review and Meta-Analysis

  • Scientific Review

Neu im Fachgebiet Chirurgie

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

US-Team empfiehlt Gastropexie nach Hiatushernien-Op.

Zur Vermeidung von Rezidiven nach Reparatur einer paraösophagealen Hiatushernie sollte einem US-Team zufolge der Magen bei der Op. routinemäßig an der Bauchwand fixiert werden. Das Ergebnis einer randomisierten Studie scheint dafür zu sprechen.

Mit Lidocain kommt der Darm nicht schneller in Schwung

Verzögertes Wiederanspringen der Darmfunktion ist ein Hauptfaktor dafür, wenn Patientinnen und Patienten nach einer Kolonresektion länger als geplant im Krankenhaus bleiben müssen. Ob man diesem Problem mit Lidocain vorbeugen kann, war Thema einer Studie.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise