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

Eur J Cardiothorac Surg. 2009 Jul;36(1):181-4. doi: 10.1016/j.ejcts.2009.04.022. Epub 2009 May 27.

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?

Publication types

  • Editorial
  • Practice Guideline

MeSH terms

  • Algorithms
  • Combined Modality Therapy
  • Evidence-Based Medicine
  • Exercise Test
  • Health Status Indicators
  • Humans
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / surgery
  • Lung Neoplasms / therapy*
  • Respiratory Function Tests
  • Risk Assessment / methods