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W. Walker



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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-033 - Video-Assisted Thoracoscopic Surgery (VATS) Lobectomy: A Consensus Statement (ID 2246)

      09:30 - 09:30  |  Author(s): W. Walker

      • Abstract

      Background
      Video-assisted thoracoscopic surgery (VATS) lobectomy has been gradually accepted as an alternative surgical approach to open thoracotomy for selected patients with non-small cell lung cancer (NSCLC) over the past 20 years. The aim of this project was to standardize the perioperative management of VATS lobectomy patients through expert consensus and to provide insightful guidance to clinical practice.

      Methods
      A panel of 55 experts on VATS lobectomy was identified by the Scientific Secretariat and the International Scientific Committee of the ‘20[th] Anniversary of VATS Lobectomy Conference – The Consensus Meeting’. The Delphi methodology consisting of two rounds of voting was implemented to facilitate the development of consensus. Results from the second-round voting formed the basis of the current Consensus Statement. Consensus was defined a priori as more than 50% agreement amongst the panel of experts. Clinical practice was deemed ‘recommended’ if 50-74% of experts reached agreement and ‘highly recommended’ if 75% or more of experts reached agreement.

      Results
      Fifty VATS lobectomy experts (91%) from 16 countries completed both rounds of standardized questionnaires. No statistically significant differences in the responses between the two rounds of questioning were identified. Consensus was reached on 21 controversial points, outlining the current accepted definition of VATS lobectomy, its indications and contraindications, perioperative clinical management, as well as recommendations for training and future research directions. Figure 1 Figure 2

      Conclusion
      The present Consensus Statement represents a collective agreement amongst 50 international experts to establish a standardized practice of VATS lobectomy for the thoracic surgical community after 20 years of clinical experience.

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    P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.12-020 - Cross-sectional Survey on Lobectomy Approach (X-SOLA) (ID 2809)

      09:30 - 09:30  |  Author(s): W. Walker

      • Abstract

      Background
      To improve the understanding of current attitudes of the thoracic community to video-assisted thoracoscopic surgery (VATS) lobectomy, the Collaborative Research Group conducted the Cross-sectional Survey On Lobectomy Approach (X-SOLA) study. The aim was three-fold: to assess the practice of lobectomy in the current clinical setting, to identify potential reasons that may inhibit the popularization of the VATS lobectomy technique, and to hypothesize potential strategies that can advance this field in the future.

      Methods
      Participants included thoracic surgeons identified through an index search from the Web of Science and the cardiothoracic surgery network. A confidential questionnaire was emailed in June, 2012. Non-responders were given two reminder emails at monthly intervals.

      Results
      838 thoracic surgeons completed the questionnaire within a three-month period, including 416 surgeons who only performed lobectomy through open thoracotomy and 422 surgeons who performed VATS or robotic-VATS. Two sets of standardized questionnaires were completed by these two groups. Ninety-five percent of VATS surgeons agreed with the definition of ‘true’ VATS lobectomy according to the CALGB trial. Ninety-two percent of surgeons who did not perform VATS lobectomy were prepared to learn this technique, but were hindered by limited resources, exposure and mentoring. Both groups believed VATS lobectomy should be incorporated into thoracic surgical training and for more standardized workshops to be made available. Figure 1 Figure 1. Survey responses for surgeons who performed video-assisted thoracoscopic surgery lobectomy (n=422) Figure 2

      Conclusion
      The X-SOLA study represents the largest cross-sectional report within the thoracic community to date, demonstrating the current status of clinical practice of lobectomy approach for NSCLC worldwide and identifying areas in need of further development.