ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe.

The European Respiratory Society (ERS) task force for harmonised standards for lung cancer registration and lung cancer services in Europe recognised the need to create a single dataset for use in pan-European data collection and a manual of standards for European lung cancer services.The multidisciplinary task force considered evidence from two different sources, reviewing existing national and international datasets alongside the results of a survey of clinical data collection on lung cancer in 35 European countries. A similar process was followed for the manual of lung cancer services, with the task force using existing guidelines and national or international recommendations for lung cancer services to develop a manual of standards for services in Europe.The task force developed essential and minimum datasets for lung cancer registration to enable all countries to collect the same essential data and some to collect data with greater detail. The task force also developed a manual specifying standards for lung cancer services in Europe.Despite the wide variation in the sociopolitical landscape across Europe, the ERS is determined to encourage the delivery of high-quality lung cancer care. Both the manual of lung cancer services and the minimum dataset for lung cancer registration will support this aspiration.

ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update.

The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB.

Diaphragm motion and lung function prediction in patients operated for lung cancer--a pilot study on 27 patients.

BACKGROUND: The influence of the diaphragm motion to the accuracy of postoperative lung function prediction after the lung resction is still debatable. METHODS: Prospective study that included 27 patients who underwent a lung resection for cancer. Diaphragm movements were assessed radiographically and by ultrasonography before the operation and postoperatively, with the lung fully expanded. The relationship between the diaphragm movements and differences between ppo FEV1 and measured postoperative FEV1, was analysed by expressing diaphragm movements as preoperative diaphragm amplitudes, preoperative-postoperative amplitude differences or in relation to fixed intrathoracic distances. RESULTS: The mean difference between preoperative and postoperative diaphragm amplitudes of the diseased side was 2.42 ± 1.25 cm and 2.11 ± 2.04 cm when measured radiographically and by ultra sound respectively (p > 0.05). A significant positive correlation was found for the entire group only between the patients' height and the differences ppo FEV1 - actual FEV1: the prediction was more unprecise in taller patients. With the cut-off value of 550 ml for differences between ppo FEV1 and actual FEV1, a significant inverse correlation was found only if the preoperative ipsilateral diaphragm amplitude was presented as a percentage of the preoperative apex-base distance in inspiration. For right-sided tumours, the greater the difference between preoperative and postoperative ipsilateral diaphragm amplitudes, the greater discrepancy between predicted and actual postoperative FEV1. For left-sided tumours, inverse correlation existed if the preoperative diaphragm amplitude was presented as a percentage of the preoperative distance apex-base. CONCLUSION: Diaphragm movements influence the accuracy of the postoperative lung function prediction.

Influence of chronic obstructive pulmonary disease on postoperative lung function and complications in patients undergoing operations for primary non-small cell lung cancer.

OBJECTIVES: Recent data have suggested that there is a flexibility of borderline values of lung function tests in allowing safe lung resection. The aim of this study was to assess the pattern of postoperative lung function change in patients with chronic obstructive pulmonary disease compared with that of patients with normal lung function, and to compare the operative morbidity and mortality between these groups. METHODS: The study included 35 patients with chronic obstructive pulmonary disease and a control group of 47 patients with normal lung function who underwent lung resection for non-small cell lung cancer. The percent changes of lung function parameters after lung resection and operative morbidity and mortality were compared between groups. RESULTS: The mean postoperative loss in forced expiratory volume in the 1st second was significantly less in patients with chronic obstructive pulmonary disease who underwent lobectomy compared with that of patients with normal lung function (11.88% vs 24.6%, P < .05); forced expiratory flows at low lung volumes (50% and 25%) improved in patients who underwent lobectomy. The lung function change after pneumonectomy followed the same trend as that after lobectomy. In patients with chronic obstructive pulmonary disease, forced expiratory volume in the 1st second and small airways function significantly improved after preoperative bronchodilator therapy. In the group with chronic obstructive pulmonary disease, operative mortality was 0 and operative morbidity was 51.43%. CONCLUSIONS: Because the pattern of lung function change is different in patients with chronic obstructive pulmonary disease compared with that of patients with normal lung function, surgery can be offered to carefully selected patients with lung cancer, even in the presence of severely limited lung function.