Abstracts 22nd European Conference on General Thoracic Surgery June 15-18, 2014, Copenhagen, Denmark

Objectives: The objective of this study was to clarify the clinical features of patients who need home oxygen therapy (HOT) after surgical resection for lung cancer, and the predictor of permanent HOT. Methods: A retrospective chart review of 1136 patients who had undergone pulmonary resection for lung cancer and preoperative spirometry about vital capacity (VC), forced expiratory volume in one second (FEV1.0) and diffusing capacity for carbon monoxide (DLCO) between February 2008 and September 2013 was performed. Patients were divided into 3 groups: Group 1, no need of HOT; Group 2, transient HOT (patients needed HOTat discharge but left HOT after that); Group 3, permanent HOT. Group 1 consisted of 1084 patients (95.4%), Group 2 consisted of 30 patients (2.6%), and Group 3 consisted of 22 patients (1.9%). Results: FEV1.0/FVC, %FEV1.0 and %DLCO were significantly lower in Group 2 and 3 than Group 1 (67.2 vs 73.3%, 82.7 vs 93.2%, 44.1 vs 63.0%, P< 0.001, respectively). Pack-year index was significantly higher in Group 2 and 3 than Group 1 (1231.8 vs 571.5, P< 0.001). The cumulative survival at 5 years was 78.4% in Group 1 and 38.7% in Group 2 and 3 (P< 0.001). %VC, %DLCO and predicted postoperative %DLCO (% PPO DLCO) were significantly lower in Group 3 than Group 2 (82.7 vs 97.1%, P < 0.01, 36.7 vs 46.0%, P < 0.05, 26.9 vs 37.8%, P< 0.01, respectively). The cumulative survival at 5 years of Group 2 was 61.4% and that at 2 years of Group 3 was 21.7% (P< 0.001). Multivariate analysis revels that %DLCO and pack-year index were associated with postoperative HOT (Group 2 and 3), and %VC and % PPO DLCO were associated with permanent HOT (Group 3). Conclusions: Preoperative spirometry is useful for identifying those patients at increased risk of HOT after pulmonary resection. In postoperative HOT cases, the patients with low %VC or % PPO DLCO tend to need permanent HOT. Disclosure: No significant relationships.