The lung function tests and 6MWT in lung cancer patients over 80 years – the essential tools in preoperative physiological assessment.

The epidemiological data show the highest incidence of lung cancer in patients 75-85 years old. The current guidelines of preoperative evaluation indicate predicted postoperative FEV1>60% and DLCO>60% as a low risk of perioperative complications. There are no specific recommendations to older adults. Material and method: The study aimed to assess spirometry, DLCO and 6MWT in patients over 80 years (mean 82±2,1 yr.; 103 pts, 51 women). The LFTs were performed according to ERS/ATS 2019 (Master Screen, Jaeger). The statistic was done with MedCalc 12.3.0. <bold>Results:</bold> The airway obstruction FEV1%FVC<LLN was found in 30 pts (29%), DLCO<LLN occurred in 38 (36,9%). The average distance in 6MWT was 362±91m, and mean desaturation was 1,2±1,3%. Of the group, 86 pts were qualified for surgery. According to postoperative complication (PC) of various origins, the subgroups were compared: 20 patients with and 66 without PC. The significant differences were: FEV1 81,3 vs. 94,1% predicted, ppoFEV1 68,3 vs. 81,5%, desaturation in 6MWT 1,9 vs. 1,0%. The ROC analysis indicated FEV1<100% predicted and TLCO<62% predicted as discriminating values for PC. The airway obstruction was associated with a higher risk of PC (RR 2,1621; 95% CI 1,0415 to 4,4884, p= 0,0385; OR 2,8722; 95% CI 1,0418 to 7,9190, p=0,0414). <bold>Conclusion:</bold> The lung cancer patients over 80 years, eligible for surgery, have relatively well-preserved lung function and exercise capability. Despite this, patients with airway obstruction, even mild or moderate, and slight desaturation during 6MWT appeared to be prone to postoperative complications. Thus, the senior population needs cautious preoperative evaluation.