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The following is a summary of “Clinical significance of preserving pulmonary function after lung resection in early-stage non-small cell lung cancer,” published in the January 2024 issue of Oncology by Tsubokawa et al.

In this retrospective study, comprising 485 patients undergoing lobectomy or segmentectomy for early-stage non-small cell lung cancer (NSCLC), with tumors ≤2cm and clinical stage IA, the correlation between changes in pulmonary function before and after surgery and subsequent prognosis was investigated. Multivariable Cox regression analysis revealed that the reduction rate in vital capacity (VC) at 12 months postoperatively emerged as an independent prognostic factor for overall survival (OS) (hazard ratio, 1.05; 95% CI, 1.02–1.07; P<.001), while such associations were not observed for forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Stratifying OS into good and poor outcomes based on a 20% reduction rate in VC indicated significantly worse OS and recurrence-free survival (RFS) for cases with a reduction rate exceeding 20% (5-year OS: 82.0% vs. 93.4%; P=.0004, 5-year RFS: 80.3% vs. 89.8%; P=.0018). The multivariable logistic analysis also identified lobectomy as a risk factor for a reduction rate in VC higher than 20% (odds ratio, 1.61; 95%CI, 1.01–2.56; P=.045). 

In conclusion, a postoperative decrease in VC was significantly associated with prognosis, emphasizing the importance of preserving pulmonary function for the survival of patients with early-stage NSCLC. These findings underscore the clinical significance of monitoring and maintaining pulmonary function after lung resection, particularly in lobectomy, and suggest potential benefits in adopting strategies to mitigate such declines in vital capacity for improved patient outcomes.

Source: sciencedirect.com/science/article/abs/pii/S1525730424000056