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Changes in Pulmonary Function Tests After Neoadjuvant Therapy Predict Postoperative Complications
Annals of Thoracic Surgery, 09/01/09

Cerfolio RJ et al. – A decrease in the percent diffusion capacity of the lung for carbon monoxide corrected for the alveolar volume after neoadjuvant chemotherapy or chemoradiotherapy may predict increased risk for pulmonary resection, especially if the decrease is 8% or greater. These results should be considered in the preoperative risk assessment of patients who are to undergo pulmonary resection after induction therapy.

Exclusive Author Commentary
Dr Bryant, 09/02/09

Our study findings show that the change in the PFTs (FEV%, DLCO%, DLCO/VA%), rather than absolute values, after neo-adjuvant therapy was a predictor of operative risk in patients who undergo pulmonary resection. We were surprised to find that the change in FEV1% was not a good predictor and instead, the changes in the DLCO% and DLCO/VA% were better predictors of operative risk. A multivariable analysis showed that the change in DLCO/VA% remained a consistent predictor of operative risk. We recommend that patients who are potential candidates for lung surgery have PFTs performed both before and after neo-adjuvant therapy and those patients who have a decrease of 8% or more in their DLOC% and/or their DLCO/VA% may be at increased risk of surgery. They should have their surgery delayed and the PFTs repeated to ensure the DLCO% and DLCO/VA% have increased prior to elective resection if possible.

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The Influence of Chronic Heart Failure on Pulmonary Function Tests in Patients Undergoing Orthotopic Heart Transplantation
Transplantation Proceedings, 11/12/09 Relevance Score: 80%

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