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

This Article Full Text 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 Author home page(s): Alessandro Brunelli Gaetano Rocco Gonzalo Varela Marc Licker Mark K. Ferguson Thida Win Permission Requests Google Scholar Articles by Brunelli, A. PubMed Articles by Brunelli, A. Related Collections Lung - cancer Lung - other Education

Guideline

The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer

^a Division of Thoracic Surgery, Umberto I Regional Hospital, Ancona, Italy
^b Service de Physiologie et d’Explorations Fonctionnelles Hopitaux Universitaires de Strasbourg, France
^c Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa
^d Division of Thoracic Surgery, National Cancer Institute, Pascale Foundation, Naples, Italy
^e Department of Intensive Care Unit and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles (ULB), Brussels, Belgium
^f Division of Thoracic Surgery, Salamanca University Hospital, Spain
^g Department of Anesthesiology, Pharmacology and Intensive Care, Faculty of Medicine, University Hospital of Geneva, Switzerland
^h Department of Surgery, The University of Chicago, USA
ⁱ Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
^j Division of Respiratory Medicine, Medizinische Klinik-Innenstadt, Ludwig-Maximilians-University, Munich, Germany
^k Institute of Respiratory Diseases, University of Modena-Reggio Emilia, Pavullo, Italy
^l Respiratory Medicine, Lister Hospital, Stevenage, UK
^m Department of Radiation Oncology (Maastro clinic), Maastricht University Medical Center, GROW, Maastricht, The Netherlands
ⁿ Division of General Internal Medicine, Columbia University, New York, USA

Received 5 March 2009; received in revised form 14 April 2009; accepted 15 April 2009.

^_* Corresponding author. Tel.: +39 0715964433; fax: +39 0715964481. (Email: alexit_2000{at}yahoo.com; anne.Charloux{at}chru-strasbourg.fr).
^_** Corresponding author. Address: Pôle de Pathologie Thoracique, Service de Physiologie et d’Explorations Fonctionnelles, Nouvel Hopital Civil, Hopitaux Universitaires de Strasbourg, BP426, Strasbourg Cedex 67091, France. Tel.: +33 0 3 88 69 55 08 79. (Email: alexit_2000{at}yahoo.com; anne.Charloux{at}chru-strasbourg.fr).

Abstract

The European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS) established a joint task force with the purpose to develop clinical evidence-based guidelines on evaluation of fitness for radical therapy in patients with lung cancer. The following topics were discussed, and are summarized in the final report along with graded recommendations: Cardiologic evaluation before lung resection; lung function tests and exercise tests (limitations of ppoFEV1; DLCO: systematic or selective?; split function studies; exercise tests: systematic; low-tech exercise tests; cardiopulmonary (high tech) exercise tests); future trends in preoperative work-up; physiotherapy/rehabilitation and smoking cessation; scoring systems; advanced care management (ICU/HDU); quality of life in patients submitted to radical treatment; combined cancer surgery and lung volume reduction surgery; compromised parenchymal sparing resections and minimally invasive techniques: the balance between oncological radicality and functional reserve; neoadjuvant chemotherapy and complications; definitive chemo and radiotherapy: functional selection criteria and definition of risk; should surgical criteria be re-calibrated for radiotherapy?; the patient at prohibitive surgical risk: alternatives to surgery; who should treat thoracic patients and where these patients should be treated?

Key Words: Lung cancer • Pulmonary resection • Radical treatment • Preoperative evaluation • Functional evaluation