HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Iizasa, T. Articles by Fujisawa, T. Search for Related Content PubMed Articles by Iizasa, T. Articles by Fujisawa, T. Related Collections Lung - cancer Related Article

Ann Thorac Surg 2005;79:2198
© 2005 The Society of Thoracic Surgeons

---

Correspondence

Reply

Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba, 260-8670 Japan

(E-mail: fujisawat{at}faculty.chiba-u.jp).

To the Editor:

We appreciate the comments of Dr Pramesh and colleagues on our article, but would like to provide some clarification. They suggest that we have recommended limited surgery to patients with a percentage of forced expiratory volume in 1 second (FEV1%) < 70%. However, FEV1% is a continuous variable, and we compared all statistically significant prognostic factors with the continuous variables of age, pack-years, FEV1%, percentage of forced vital capacity, and PaCO₂. Each border of 60% and 70% FEV1% is not related to a border between lobectomy and limited surgery, and we do not mean to recommend that lobectomy be withheld from all patients with a preoperative FEV1% < 70%.

Moreover, we also had the same experience with the volume reduction effect after lobectomy in severe chronic obstructive pulmonary disease patients as they and D’Amico [1] pointed out [2]. However, Pramesh and colleagues do not claim that patient lung function is normalized; they simply report that lung function improves. They do not discuss a correlation of long-term survival with lung function.

We cannot confirm a lower limit of FEV1% for lobectomy of nonsmall cell lung carcinoma (NSCLC) patients from our data, just as an upper age limit for lobectomy cannot be determined. The aim of this retrospective study was not to decide a cutoff point of lung function for lobectomy in stage I NSCLC, but to consider a lower preoperative FEV1%, as well as other prognostic factors to reflect postoperative long-term survival in these cases. Hereafter, we would evaluate more cases of limited surgery with our results, taking into account the perioperative death rates of patients with a lower percentage of forced expiratory volume in 1 second comprehensively as well.

	References

Top References

 

1. D’Amico TA. Preoperative pulmonary function as a prognostic factor for stage I non-small cell lung carcinoma Ann Thorac Surg 2004;77:1902-1903.[Free Full Text]
2. Korst RJ, Ginsberg RJ, Ailawadi M, et al. Lobectomy improves ventilatory function in selected patients with server COPD Ann Thorac Surg 1998;66:898-902.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Iizasa, T. Articles by Fujisawa, T. Search for Related Content PubMed Articles by Iizasa, T. Articles by Fujisawa, T. Related Collections Lung - cancer Related Article