Preoperative Peak Oxygen Consumption: A Predictor of Survival in Resected Lung Cancer

The peak oxygen consumption (VO(2) 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(2) peak in lung cancer patients has not been investigated extensively. The aim of this study was to evaluate the impact of the preoperative VO(2) 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(2) peak ranged from 10.2 to 51.8 mL/kg/min (mean: 18.3 ± 4.6), VO(2) 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(2) peak ≥ 60% with predicted VO(2) peak < 60% showed overall survival of 30% and 17%, respectively (p < 0.001) and non-tumour-related survival of 71% and 51% (p = 0.001) at 10 years. In multivariable Cox analysis, overall 10-year survival correlated with a high predicted VO(2) peak% (p = 0.001) and low N-stage corresponding to N0 and N1 (p < 0.001). Non-tumour-related death correlated with low VO(2) peak% of predicted (p = 0.001), and age (p < 0.001). Low preoperative VO(2) peak was associated with both decreased postoperative overall survival and decreased non-tumour-related survival during the 10-year follow-up.