National Emphysema Treatment Trial (NETT-BioLINCC)

Data Access NOTE: Please refer to the “Authorized Access” section below for information about how access to the data from this accession differs from many other dbGaP accessions.

Available Data: The current release of the NETT study dataset includes follow-up data through May of 2013.

Objectives: To compare lung-volume-reduction surgery with medical therapy for severe emphysema, and to identify participant selection criteria for lung volume reduction surgery.

Background: Lung-volume-reduction surgery has been proposed as a palliative treatment for severe emphysema. Effects on mortality, the magnitude and durability of benefits, and criteria for the selection of participants have not been established.

Participants: A total of 1,218 participants with severe emphysema underwent pulmonary rehabilitation and were randomly assigned at 17 centers to undergo lung-volume-reduction surgery (bilateral stapled wedge resection) or to receive continued medical treatment. Participants were randomized after a 6-10 week pulmonary rehabilitation period and participants with a forced expiratory volume in one second (FEV1) that was 20 percent or less of predicted and a homogeneous distribution of emphysema or carbon monoxide diffusing capacity 20 percent or less of predicted were not eligible for randomization due to poor post-surgery prognosis for death or functional improvement.

Conclusions: Overall, lung-volume-reduction surgery increases the chance of improved exercise capacity but does not confer a survival advantage over medical therapy. It does yield a survival advantage for participants with both predominantly upper-lobe emphysema and low base-line exercise capacity. Participants previously reported to be at high risk and those with non-upper-lobe emphysema and high base-line exercise capacity are poor candidates for lung-volume-reduction surgery, because of increased mortality and negligible functional gain. ([NEJM 2003;348:2059-2073](https://www.nejm.org/doi/full/10.1056/NEJMoa030287)).