Lindenmann Joerg, Fink-Neuboeck Nicole, Fediuk Melanie, Maier Alfred, Kovacs Gabor, Balic Marija, Smolle Josef, Smolle-Juettner Freyja Maria
Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria.
Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
Cancers (Basel). 2020 Mar 31;12(4):836. doi: 10.3390/cancers12040836.
The peak oxygen consumption (VO peak) serves as a prognostic factor in cardio-respiratory diseases and plays an important role in cancer patients. The long-term prognostic relevance of VO peak in lung cancer patients has not been investigated extensively. The aim of this study was to evaluate the impact of the preoperative VO peak on the postoperative long-term survival in patients with operated lung cancer. Retrospective analysis of 342 patients with curatively resected non-small-cell lung cancer using a multivariate Cox proportional hazard model. Results: Preoperative VO peak ranged from 10.2 to 51.8 mL/kg/min (mean: 18.3 ± 4.6), VO peak % of predicted ranged from 32 to 172% (mean: 65.2 ± 18.0%). Overall 10-year survival was 23%. A Log-rank test comparing predicted VO peak ≥ 60% with predicted VO peak < 60% showed overall survival of 30% and 17%, respectively ( < 0.001) and non-tumour-related survival of 71% and 51% ( = 0.001) at 10 years. In multivariable Cox analysis, overall 10-year survival correlated with a high predicted VO peak% ( = 0.001) and low N-stage corresponding to N0 and N1 ( < 0.001). Non-tumour-related death correlated with low VO peak% of predicted ( = 0.001), and age ( < 0.001). Low preoperative VO peak was associated with both decreased postoperative overall survival and decreased non-tumour-related survival during the 10-year follow-up.
峰值耗氧量（VO₂峰值）是心肺疾病的一个预后因素，在癌症患者中也起着重要作用。VO₂峰值在肺癌患者中的长期预后相关性尚未得到广泛研究。本研究的目的是评估术前VO₂峰值对接受手术的肺癌患者术后长期生存的影响。采用多变量Cox比例风险模型对342例接受根治性切除的非小细胞肺癌患者进行回顾性分析。结果：术前VO₂峰值范围为10.2至51.8 mL/kg/min（平均：18.3±4.6），预测VO₂峰值百分比范围为32%至172%（平均：65.2±18.0%）。总体10年生存率为23%。将预测VO₂峰值≥60%与预测VO₂峰值<60%进行对数秩检验，结果显示10年时总体生存率分别为30%和17%（P<0.001），非肿瘤相关生存率分别为71%和51%（P = 0.001）。在多变量Cox分析中，总体10年生存率与高预测VO₂峰值百分比（P = 0.001）和对应N0和N1的低N分期相关（P<0.001）。非肿瘤相关死亡与低预测VO₂峰值百分比（P = 0.001）和年龄（P<0.001）相关。术前低VO₂峰值与10年随访期间术后总体生存率降低和非肿瘤相关生存率降低均有关联。
