In this issue of CHEST (see page 21), Handy and colleagues report their prospective survey of 139 patients undergoing surgical resection for lung cancer. This was a study carried out at three hospitals. They compared functional health status and quality of life using the SF-36 and the quality of life index (QLI). They attempted to stratify outcomes and quality of life following thoracic surgery as a function of preoperative FEV1, 6-min walk distance, diffusing capacity of the lung for carbon monoxide (Dlco), use of chemoradiation, extent of resection, and postoperative complications comparing to age-matched control subjects without lung cancer. The authors found that preoperative functional health status in lung cancer patients is significantly impaired and persisted 6 months following lung resection. They further concluded that impaired Dlco, not FEV1, is a poor prognostic predictor of postoperative quality of life. Although the ability of the preoperative lung to perform gas exchange (Dlco) may in fact be more important than its mechanical behavioral properties (FEV1) in determining surgical results, we would caution against the use of Dlco as the sole preoperative measure of surgical candidacy based on the findings of this group. Traditional surgical literature has suggested poorer surgical prognosis with preoperative FEV1 < 60%, and a preoperative FEV1 < 40% should be considered a contraindication to resection.4 Handy and colleagues stratified their results into preoperative FEV1 of < 40%, 40 to 79%, and > 79% predicted groups. It would be interesting to see other supportive reports using traditional limits for FEV1 in a similar study.