{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:19:09Z","timestamp":1783570749805,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pusan National University Hospital in 2024"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We examined whether cardiopulmonary exercise testing (CPET) variables predict 30\u2011day postoperative complications in patients undergoing anatomical resection for non\u2013small cell lung cancer (NSCLC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients who underwent segmentectomy or greater between January 2023 and March 2025 at a single tertiary centre were reviewed. All patients underwent CPET within 30 days preoperatively. Data on demographics, comorbidities, pulmonary function, operative factors, and outcomes were collected. Associations were assessed using univariable and multivariable logistic regression; discrimination was evaluated with receiver operating characteristic curve (ROC). Results with 2\u2011sided \u03b1\u2009=\u20090.05 were considered significant. Statistical analyses were conducted with R 4.4.2 (stats).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 353 patients (mean age 68.4\u2009\u00b1\u20098.4 years; 58.1% male individuals), 33 (9.4%) experienced complications. Patients were older (71.8 vs 68.0 years) and more often male individuals (81.8% vs 55.6%) than controls; they had lower body mass index (BMI) (23.1 vs 24.4 kg\/m2) and lower forced expiratory volume in 1 second\/forced vital capacity (FEV1\/FVC) (69.5% vs 72.7%). In the univariable analysis, age (odds ratio [OR] 1.07), female sex (OR 0.28 vs male), BMI (OR 0.88 per kg\/m2), FEV1\/FVC (OR 0.96 per %), ventilatory equivalent for carbon dioxide (VE\/VCO2) slope (OR 1.06 per unit), attained stage (OR 0.66 per stage), and operation time (OR 1.58 per hour) were associated with complications. In the multivariable analysis, BMI (OR 0.86, 95% confidence interval [CI] 0.75-1.00), FEV1\/FVC (OR 0.94, 95% CI, 0.90-0.99), and VE\/VCO2 slope (OR 1.06, 95% CI, 1.00-1.11) remained independent predictors. Receiver operating characteristic curves showed poor discrimination: peak oxygen consumption (VO2peak) area under the curve (AUC), 0.52; anaerobic threshold (AT), 0.59; VE\/VCO2 slope, 0.40; and AT time 0.43. Dichotomized cut\u2011offs were generally non\u2011informative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual CPET variables had limited discriminative accuracy (AUC &amp;lt; 0.6). Cardiopulmonary exercise testing should complement clinical and spirometric predictors rather than serve as a stand\u2011alone gatekeeper.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag173","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:39:35Z","timestamp":1782214775000},"source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Cardiopulmonary Exercise Testing and 30-Day Postoperative Complications After Lung Resection for Non\u2013Small Cell Lung Cancer: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-8582","authenticated-orcid":false,"given":"Jonggeun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan 49241,","place":["Korea"]},{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Kyung Hee University Medical Center , Seoul 02447,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9512-8909","authenticated-orcid":false,"given":"Ho Seong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan 49241,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Su","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan 49241,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeong Dae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan 49241,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Yeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan 49241,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital , Busan, 49241,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026070900113987400_ivag173-B1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1183\/09031936.00184308","article-title":"ERS\/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)","volume":"34","author":"Brunelli","year":"2009","journal-title":"Eur Respir J"},{"key":"2026070900113987400_ivag173-B2","doi-asserted-by":"publisher","first-page":"e166S","DOI":"10.1378\/chest.12-2395","article-title":"Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Brunelli","year":"2013","journal-title":"Chest"},{"key":"2026070900113987400_ivag173-B3","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/S0022-5223(19)35157-8","article-title":"Diffusing capacity predicts morbidity and mortality after pulmonary resection","volume":"96","author":"Ferguson","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026070900113987400_ivag173-B4","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezad337","article-title":"Increased minute ventilation-to-carbon dioxide slope during cardiopulmonary exercise test is associated with poor postoperative outcome following lung cancer resection","volume":"2024","author":"Rushwan","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026070900113987400_ivag173-B5","doi-asserted-by":"publisher","first-page":"e0272984","DOI":"10.1371\/journal.pone.0272984","article-title":"Ventilatory efficiency is superior to peak oxygen uptake for prediction of lung resection cardiovascular complications","volume":"17","author":"Mazur","year":"2022","journal-title":"PLoS One"},{"key":"2026070900113987400_ivag173-B6","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.lungcan.2018.10.003","article-title":"Minute ventilation-to-carbon dioxide slope is associated with postoperative survival after anatomical lung resection","volume":"125","author":"Miyazaki","year":"2018","journal-title":"Lung Cancer"},{"key":"2026070900113987400_ivag173-B7","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1016\/j.athoracsur.2021.11.073","article-title":"Prediction of postoperative complications: ventilatory efficiency and rest end-tidal carbon dioxide","volume":"115","author":"Brat","year":"2023","journal-title":"Ann Thorac Surg"},{"key":"2026070900113987400_ivag173-B8","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1136\/thoraxjnl-2021-217242","article-title":"Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis","volume":"77","author":"Gravier","year":"2022","journal-title":"Thorax"},{"key":"2026070900113987400_ivag173-B9","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.bjane.2021.02.003","article-title":"Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study","volume":"71","author":"Bevilacqua Filho","year":"2021","journal-title":"Braz J Anesthesiol"},{"key":"2026070900113987400_ivag173-B10","doi-asserted-by":"publisher","first-page":"e431","DOI":"10.1016\/j.cllc.2024.07.015","article-title":"Physical exercise during neoadjuvant treatments for non-small cell lung cancer: the time is coming","volume":"25","author":"Avancini","year":"2024","journal-title":"Clin Lung Cancer"},{"key":"2026070900113987400_ivag173-B11","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1378\/chest.08-2059","article-title":"Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in candidates to major lung resection","volume":"135","author":"Brunelli","year":"2009","journal-title":"Chest"},{"key":"2026070900113987400_ivag173-B12","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1007\/s12672-024-01079-w","article-title":"Effect of exercise on postoperative recovery of patients with non-small cell lung cancer: a systematic review and meta-analysis","volume":"15","author":"Jiao","year":"2024","journal-title":"Discov Oncol"},{"key":"2026070900113987400_ivag173-B13","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.rmed.2015.08.009","article-title":"Preoperative exercise therapy in lung surgery patients: a systematic review","volume":"109","author":"Pouwels","year":"2015","journal-title":"Respir Med"},{"key":"2026070900113987400_ivag173-B14","doi-asserted-by":"publisher","first-page":"PA3773","DOI":"10.1183\/13993003.congress-2023.PA3773","article-title":"Prehabilitation in lung cancer surgery: a review and meta-analysis of RCT studies","volume":"62","author":"Athanassiadi","journal-title":"Eur Respir J"},{"key":"2026070900113987400_ivag173-B15","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1093\/bja\/aeu318","article-title":"Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study","volume":"114","author":"West","year":"2015","journal-title":"Br J Anaesth"},{"key":"2026070900113987400_ivag173-B16","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.pmr.2016.09.002","article-title":"Surgical prehabilitation in patients with cancer: state-of-the-science and recommendations for future research from a panel of subject matter experts","volume":"28","author":"Carli","year":"2017","journal-title":"Phys Med Rehabil Clin"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag173\/68605612\/ivag173.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/7\/ivag173\/68605612\/ivag173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/7\/ivag173\/68605612\/ivag173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:11:41Z","timestamp":1783570301000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag173\/8715504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag173","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,6,24]]},"article-number":"ivag173"}}