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Lung volume reduction surgery shown to prolong and improve life for some emphysema patients
Date:7/23/2009

edical care. The patients were followed for five years or until they died. All endpoints except death were measured at six-month intervals. The primary outcome was a composite endpoint consisting of death or an "unquestionable and meaningful deterioration" in quality of life, defined as an 8-point or greater drop on the Saint George's Respiratory Questionnaire, a widely used standardized measure of quality of life in patients with respiratory disease.

In the total sample, the average time until a "composite event"either death or a serious decline in quality of life was one year for medically treated patients and two years for patients who had undergone LVRS. Patients whose emphysema was predominantly found in the upper lobes of their lungsabout 65 percent of emphysema patients also showed quality of life and survival benefits greater than survival benefits alone, suggesting that they lived longer and better.

However, LVRS has a small but inherent danger of perioperative mortality.

"LVRS has risks that patients need to understand and acknowledge," said Dr. Benzo. "In NETT, close to five percent of the patients undergoing lung reduction died in the post-operative period. However, once the post operative period is over, the quality of life benefit comes right away."

"NETT was landmark study: randomization was necessary at that point as we did not know the true benefits of the surgery," said Dr. Benzo. "We now know the individuals that benefit from it. Randomization would be unethical now in the group of individuals that we now know get benefit. This study shed light on the palliative (overall well-being) benefits of the surgery, which many patients consider as important as the survival benefit


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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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