Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study.

BACKGROUND: In non-small-cell lung cancer patients, high peak oxygen uptake (peak ...) predicts lower rates of postoperative complications and better long-term survival. Neoadjuvant chemotherapy (NAC) may negatively impact peak ... METHODS: Cardiopulmonary exercise testing (CPET) was performed in 34...

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Publicado en:Respiratory Care Vol. 61; no. 8; pp. 1059 - 1067
Autores principales: Fresard, Isabelle, Licker, Marc, Adler, Dan, Lovis, Alban, Robert, John, Karenovics, Wolfram, Diaper, John
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Aug2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2016
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.4187/respcare.04299
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        atl: Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study.
      aug:
        au:
          Fresard, Isabelle
          Licker, Marc
          Adler, Dan
          Lovis, Alban
          Robert, John
          Karenovics, Wolfram
          Diaper, John
        affil: Division of Pulmonary Medicine, Geneva Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
      sug:
        subj:
          Neoadjuvant Therapy
          Carcinoma, Non-Small-Cell Lung Surgery
          Oxygen Consumption
          Human
          Cross Sectional Studies
          Exercise Test, Cardiopulmonary
          Multiple Linear Regression
          Confidence Intervals
          Switzerland
          Prospective Studies
          Respiratory Function Tests
          Male
          Female
          Adult
          Middle Age
          Aged
          Postoperative Complications
          Heart Rate Evaluation
          Aerobic Capacity
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: In non-small-cell lung cancer patients, high peak oxygen uptake (peak ...) predicts lower rates of postoperative complications and better long-term survival. Neoadjuvant chemotherapy (NAC) may negatively impact peak ... METHODS: Cardiopulmonary exercise testing (CPET) was performed in 34 consecutive stage IIIA/IIIB non-small-cell lung cancer subjects scheduled for elective lung surgery. Using multivariate linear regression adjusted for potential confounders, we compared CPET results in subjects receiving or not receiving NAC (NAC+, n = 19; NAC-, n = 15). RESULTS: Adjusted peak ... was lower in NAC + compared with NAC- subjects (-5.3 mL/min/kg [95% CI -8.3 to -2.2], P = .01). Likewise, oxygen pulse, maximal work load, and ventilatory threshold were also lower in NAC+ subjects, whereas peak heart rate and breathing reserve were similar. NAC+ subjects presented lower values of diffusion capacity for carbon monoxide (DLCO) (P = .035) and hemoglobin concentrations (P < .001). DLCO was strongly correlated with peak ... (r² = 0.56). Adjustment for DLCO reduced the effect of NAC on peak ... without suppressing it. CONCLUSIONS: NAC was associated with lower preoperative peak ... in subjects with non-small-cell lung cancer. This lower aerobic fitness may result from NAC-induced reduction in pulmonary gas exchange or heart toxicity. Since lower fitness is linked to poorer outcome, the decision for NAC may have to be balanced with its possible toxicity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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