The role of pulmonary hypertension in the postoperative evolution of lung cancer patients

Abstract

. BACKGROUND. Lung cancer continues to be a leading cause of cancer deaths globally. Pulmonary hypertension is considered an unfavorable prognostic factor and even a contraindication for major pulmonary resection. AIM. Identification of useful methods to prevent postoperative complications in patients with lung cancer and concurrent pulmonary hypertension (PH) METHODS. A review of the literature was conducted in which the searching strategy was the Google search, PubMed database and Elsevier. RESULTS. Transthoracic echocardiography is a useful method for identifying PH at PAP values >= 35 mmHg. The PAP/Ao index on chest CT determines the presence of PH as well as its etiology. Cardiac catheterization remains the gold standard for the diagnosis of PH and is not routinely performed in patients with lung cancer. Unilateral pulmonary artery occlusion is a useful additional investigative parameter that has its specific role as part of the preoperative evaluation of lung cancer patients who are candidates for major lung resections. CONCLUSIONS. The increasing incidence of lung cancer as well as the high risk of developing postoperative complications in association with PH require a vigilant approach to both respiratory and hemodynamic parameters to prevent postoperative complications. Preoperative evaluation in these patients requires a multidisciplinary approach that includes thoracic surgeons, cardiologists, anesthesiologists, and pulmonologists. Lung transplantation may be a treatment option for stage I lung cancer with severe PH