The physiologic evaluation of the lung resection candidate.

The evaluation of patients with lung cancer should include an assessment of physiologic risk. This assessment begins with simple pulmonary function studies such as spirometry and diffusing capacity. Abnormalities of these test results should stimulate further assessment with quantitative lung scanning and noninvasive exercise testing. Resection should not be recommended in patients with extremely high risk; however, because of the poor prognosis, patients must be integrally involved in the decision to not resect the lung cancer.