Disappointing Results for Lung-Volume–Reduction Surgery

The eagerly awaited National Emphysema Treatment Trial is a randomized multicenter study designed to compare lung-volume–reduction surgery (i.e., resection of 20 percent to 35 percent of each lung) with medical treatment for patients with advanced emphysema. An interim analysis by a data and safety monitoring board has identified a subgroup of patients with excessive mortality after this surgery.

Of 1033 patients enrolled in the trial as of June 2001, 140 patients (70 in the surgery group and 70 in the medical-therapy group) were at high risk by virtue of FEV₁ no higher than 20 percent of predicted and either homogeneously distributed emphysema on CT scanning or carbon monoxide diffusing capacity no more than 20 percent of predicted. Thirty-…