Stage I non-small-cell lung cancer — SCE Respiratory MCQ

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HardLung CancerStage I non-small-cell lung cancerSCE Respiratory

A lobectomy candidate has homogeneous segmental function and preoperative FEV1 68% predicted. A right upper lobectomy will remove 3 of 19 functioning segments. What is the segment-count predicted postoperative FEV1?

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Correct answer: B — 57% predicted

Explanation lettering: D = shown as A · E = shown as C · C = shown as D · A = shown as E

B is correct. Segment counting gives ppoFEV1 = preoperative FEV1 × remaining functional segments/19 = 68 × 16/19 = 57.3% predicted. Forty-six per cent incorrectly removes six segments, 62% removes fewer than three, 65% applies an arbitrary small decrement and 68% assumes no functional lung is resected. Split-function imaging is preferable when regional function is markedly heterogeneous.

Reference: https://publications.ersnet.org/content/erj/34/1/17