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J. Kawabe
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-032 - Prediction of Postoperative Lung Function in Patients with Lung Cancer by Lung Lobe (ID 8010)
09:30 - 09:30 | Author(s): J. Kawabe
- Abstract
Background:
Prediction of postoperative lung function is important in preoperative evaluation of patients with lung cancer. Postoperative predictive lung function includes a calculation method predicting from the number of bronchial branches in the non-occlusion area and a method using perfusion scintigraphy. We compared the lung function predicted from these two methods with the actual postoperative lung function and examined the correlation with each method for each lobe.
Method:
Forty seven patients underwent lung lobectomy with lung cancer of 2 cm or less from November 2015 to February 2017 were targeted. All patients were performed preoperative lung function test and perfusion scintigraphy using technetium-99m-labeled macroaggregate of albumin. In this study, cases with right middle lobectomy and bilobectomy were excluded. In all cases, lung function test was reexamined at the third to six month after surgery. The assessment of pulmonary perfusion was performed with planar imaging. Regional quantitation of lung perfusion was first assessed using the traditional method by drawing 2 regions-of-interest (ROIs) of equal size over each lung, dividing the lung into upper, middle, and lower lung zones. The mean of the counts in each of the 4 zones was calculated and compared.
Result:
Surgery was performed in 22 cases of right upper lobectomy, 10 cases of right lower lobectomy, 10 cases of left upper lobectomy and 5 cases of left lower lobectomy. Both calculation method and perfusion scintigraphy predicted postoperative FEV1 well in patients who underwent lobectomy (R= 0.94 vs R = 0.91) (both, p < 0.001). We studied upper lobectomy 32 cases and lower lobectomy 15 cases. Both methods showed significantly lower values compared with actual postoperative FEV1. In upper lobectomy cases, the average of the difference between the actual postoperative FEV1 and predicted postoperative FEV1 in calculation method was 193ml, and the average difference from predicted postoperative FEV in perfusion scintigraphy was 168ml. There was no significant difference between the two methods. In lower lobectomy cases, the average of the difference between the actual postoperative FEV1 and predicted postoperative FEV1 in calculation method was 263ml, and the average difference from predicted postoperative FEV1 in perfusion scintigraphy was 144ml. The FEV value of the calculation method was significantly lower than that of perfusion scintigraphy (p=0.0021).
Conclusion:
The conventional calculation method and perfusion scintigraphy method showed a strong correlation with actual postoperative FEV1. In lower lobectomy, the perfusion scintigraphy method showed the possibility of predicting more accurate postoperative FEV1.
