The Prognostic Value of Preoperative Evaluation of Patients Undergoing Thoracic Surgery

¹ Assistant Attending Physician, Memorial Hospital, Department of Medicine
² Associate Professor Clinical Surgery, Cornell University Medical Collage

The charts of 533 patients with lung cancer who had had thoracic surgery preceded by pulmonary function tests were reviewed in an attempt to find possible definite criteria indicating whether or not surgery would be tolerated.

Of the 533 patients, 11 died in the operating room or during the first day after surgery, 41 died before leaving the hospital, and 21 (seven living, 14 dead) developed respiratory failure. These 73 patients were considered not to have tolerated surgery. Thirty-four died of diseases other than pulmonary neoplasm, 50 are living without respiratory insufficiency (nine with cancer, 41 without), and 376 died of lung cancer. These 460 patients tolerated surgery.

Factors considered in preoperative evaluation were chronic pulmonary disease in addition to the neoplasm, cardiovascular disease, associated serious illnesses (such as diabetes, peptic ulcer, alcoholism), vital capacity and maximum breathing capacity. No significant differences could be found among any of the six clinical groups regarding the presence or absence of any of these factors, singly or in combination.

It was concluded that definite clinical criteria had not been found upon which to base the selection of patients for thoracic surgery.