Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 May;41(5):e81-6.
doi: 10.1093/ejcts/ezs049. Epub 2012 Feb 24.

Diffusing capacity predicts long-term survival after lung resection for cancer

Mark K Ferguson  1 , James J Dignam, Juned Siddique, Wickii T Vigneswaran, Amy D Celauro
Affiliations

Diffusing capacity predicts long-term survival after lung resection for cancer

Mark K Ferguson et al. Eur J Cardiothorac Surg. 2012 May.

Abstract

Objectives: Predictors of long-term survival for patients with lung cancer assist in individualizing treatment recommendations. Diffusing capacity (DLCO) is a predictor of complications after resection for lung cancer. We sought to determine whether DLCO is also prognostic for long-term survival after lung resection for cancer.

Methods: We assessed survival among patients in our prospective database who underwent lung resection for cancer between 1980-2006. Potential prognostic factors for all-cause mortality were evaluated by computing average annual hazard rates, and variables significantly associated with survival were included in multivariable Cox modelling. Multiple imputation was used to address missing values.

Results: Among 854 unique patients, there were 587 deaths. The median follow-up time from surgery was 9.6 years. Predictors of survival included age, stage, performance status, body mass index, history of myocardial infarction, renal function and DLCO. On univariate analysis, the hazard ratio increased incrementally compared with those with a DLCO of ≥ 80% (70-79%, 1.12; 60-69%, 1.29; <60%, 1.35). On multivariable analysis, DLCO was an independent predictor of long-term survival for all patients (corrected for all other important covariates; HR 1.04 per 10-point decrement; 95% CI 1.00-1.08; P = 0.05). Its prognostic ability for long-term survival was above and beyond its influence on operative mortality.

Conclusions: DLCO is an independent and clinically important determinant of long-term survival after major lung resection for cancer, a finding that is not generally known. Knowledge of this may help improve selection of patients for lung resection and may help tailor the extent of resection, when possible, in order to appropriately balance operative risk with long-term outcomes.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Survival according to preoperative DCLO for all patients. Unadjusted Kaplan–Meier plots are shown; plots adjusted for other covariates are similar.
Figure 2:
Figure 2:
Survival according to preoperative DCLO for patients not experiencing operative mortality. Unadjusted Kaplan–Meier plots are shown; plots adjusted for other covariates are similar.
See this image and copyright information in PMC

References

    1. Sekine Y, Behnia M, Fujisawa T. Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer. 2002;37:95–101. doi:10.1016/S0169-5002(02)00014-4. - DOI - PubMed
    1. Ploeg AJ, Kappetein AP, van Tongeren RB, Pahlplatz PV, Kastelein GW, Breslau PJ. Factors associated with perioperative complications and long-term results after pulmonary resection for primary carcinoma of the lung. Eur J Cardiothorac Surg. 2003;23:26–9. doi:10.1016/S1010-7940(02)00655-3. - DOI - PubMed
    1. Nakajima T, Sekine Y, Yamada Y, Suzuki H, Yasufuku K, Yoshida S, et al. Long-term surgical outcome in patients with lung cancer and coexisting severe COPD. Thorac Cardiovasc Surg. 2009;57:339–42. doi:10.1055/s-0029-1185571. - DOI - PubMed
    1. Petty TL. John Hutchinson's mysterious machine revisited. Chest. 2002;121:219S–23S. doi:10.1378/chest.121.5_suppl.219S. - DOI - PubMed
    1. Ferguson MK, Vigneswaran WT. Diffusing capacity predicts morbidity after lung resection in patients without obstructive lung disease. Ann Thorac Surg. 2008;85:1158–65. doi:10.1016/j.athoracsur.2007.12.071. - DOI - PubMed

Publication types