Maximal Oxygen Uptake--Risk Predictor of NSCLC Resection in Patients With Comorbid Emphysema: Lessons From NETT

Semin Thorac Cardiovasc Surg. 2015 Summer;27(2):225-31. doi: 10.1053/j.semtcvs.2015.07.009. Epub 2015 Aug 20.

Abstract

We compared VO2 max values from ACCP Guidelines and from NETT's homogenous NULPD surrogate for predicting operative mortalities. Estimated mid and long-term non-cancer related survival in NETT's subset was also obtained. NETT and ACCP Guideline VO2 max values were similar in the "low" and "mid" risk operative mortality categories but NETT's "high" risk subset showed lower mortality (14% vs. 26%). Estimated non-cancer related survival in NETT "low", "mid" and "high" risk VO2 max categories at two and eight years were 100%, 74%, 59% and 48%, 26%, 14%, respectively. The lower predicted risk in NETT's "high- risk" subset raises the possibility of extending indications for potential curative resection in selected patients. The NETT surrogate also provides hitherto unavailable estimate on long-term non-cancer related survival after potential curative resection of NSCLC and suggests that the operation does not shorten eight-year longevity.

Keywords: NETT surrogate; VO2 max; emphysema; lung cancer; operative mortality predictor; survival.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / physiopathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Comorbidity
  • Exercise Test
  • Exercise Tolerance
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / surgery*
  • Oxygen Consumption*
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / mortality
  • Pulmonary Emphysema / physiopathology*
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome