Spirometry: Predicting Risk and Outcome

For decades, surgery has been the mainstay of treatment in early stage lung cancer, as well as complex infectious conditions of the lung. Concomitantly, forced expiratory volume (FEV1) alone has been the discriminating parameter of surgical eligibility. Still, the limitations of FEV1 have emerged in published literature, and so carbon monoxide diffusing capacity (DLCO) has been suggested as a complementary parameter, to be introduced along with the concept of defining numeric values corresponding to the predicted postoperative figures of FEV1 and DLCO. However, recent evidence argues against the predicting ability of postoperative FEV1 and DLCO, especially in the immediate postoperative period and in patients with severe airflow limitation.