Pulmonary Function Assessment in Lung Cancer Resection

Pulmonary function assessment is central to the safe and effective management of patients undergoing lung cancer resection. Preoperative evaluation combines spirometric measurements, diffusion capacity testing and cardiopulmonary exercise testing to estimate predicted postoperative indices such as forced expiratory volume in one second (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO). Anatomical imaging techniques—most notably computed tomographic volumetry—have been integrated to quantify functional lung volume and perfusion, complementing physiological tests. Postoperative monitoring employs serial lung function tests and imaging to characterise recovery trajectories, inform rehabilitation strategies and refine patient counselling. Advances in understanding compensatory lobe growth, ventilatory efficiency markers and image‐derived functional metrics have sharpened risk stratification and perioperative decision‐making, with clear implications for patient safety, global surgical practice and long‐term outcomes.

Research from Nature Portfolio

Recent longitudinal studies have employed three‐dimensional CT reconstruction to map changes in residual lobe volumes following lobectomy. In a cohort of over 180 patients, total lung volume deficits fell from around 20 % at one month to under 6 % at twelve months post‐surgery. Compensation was most pronounced in the inferior lobes ipsilateral to the resection, exceeding growth in contralateral lobes. Correlation analyses demonstrated that one‐year volume change closely paralleled FEV1 improvement, whereas advancing age attenuated volumetric adaptation. These findings establish objective benchmarks for functional recovery, support tailored preoperative counselling and pave the way for integrating radiographic volumetry into routine follow‐up protocols.

Pulmonary Function Assessment in Lung Cancer Resection publication trend

The graph below shows the total number of articles in pulmonary function assessment in lung cancer resection across all publications each year (not limited to Nature Index journals).

Technical terms

Forced expiratory volume in one second (FEV1): The volume of air exhaled in the first second of a forced breath, a key spirometric index of airway function.

Diffusing capacity of the lung for carbon monoxide (DLCO): A measure of the lung’s capacity to transfer gas from inhaled air to the bloodstream, reflecting alveolar–capillary integrity.

Cardiopulmonary exercise testing (CPET): A dynamic evaluation combining respiratory gas analysis with exercise to assess integrative cardiovascular, pulmonary and muscular function.

Minute ventilation/carbon dioxide production slope (VE/VCO2 slope): A ventilatory efficiency parameter derived during CPET, indicating the relationship between ventilation and carbon dioxide elimination.

References

1. Longitudinal changes in the volume of residual lung lobes after lobectomy for lung cancer: a retrospective cohort study. Scientific Reports (2024).
2. Prognostic role of minute ventilation/carbon dioxide production slope for perioperative morbidity and long-term survival in resectable patients with nonsmall-cell lung cancer: a prospective study using propensity score overlap weighting. International Journal of Surgery (2023).
3. Clinical application of computed tomographic volumetric imaging in postoperative lung function assessment in patients with lung cancer. BMC Medical Imaging (2024).
4. Comparison between functional lung volume measurement and segment counting for predicting postoperative pulmonary function after pulmonary resection in lung cancer patients. BMC Pulmonary Medicine (2023).