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C.R. Thomas, Jr.



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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P1.24-001 - Validation of a Novel Superior Vena Cava Syndrome Identification, Classification, and Management Algorithm (ID 307)

      09:30 - 09:30  |  Author(s): C.R. Thomas, Jr.

      • Abstract

      Background
      Superior vena cava (SVC) syndrome results from great vessel extrinsic compression or intraluminal obstruction resulting in facial erythema, edema, or venous distension. This presentation can escalate into a life threatening condition. The Yale SVC classification system and management algorithm was proposed for tumor-related causes. We hypothesized its inclusion criteria may be limited in scope and not capture common causes and symptoms of SVC. The specific aim was to develop a SVC identification, classification, and management algorithm.

      Methods
      Retrospective data from Oregon Health & Science University pts diagnosed with ICD-9 code 459.2, compression of vein, between 2008-11 were collected. Pt demographics, vital signs, physical examination findings, hospitalization records, and outcomes were analyzed. ANOVA and Mann-Whitney U tests were utilized to assess significant between genders, p ≤ 0.05.

      Results
      The study population consisted of 207 pts; 157 were removed due to compression of a vessel other than the SVC. SVC syndrome was secondary to a malignancy (n=30), fibrotic stricture (n=5), or indwelling catheter-related thrombus (n=11). Dyspnea (n=31), facial edema (n=24), and cough (n=18) were the most common physical examination findings. Patients who presented with cough or dyspnea secondary to a malignancy, without facial, neck, or extremity edema (n=7) or those with a post-procedure fibrotic stricture (n=5) or an indwelling catheter-related thrombus (n=11) did not meet the Yale classification system inclusion criteria.

      Conclusion
      A SVC classification system, which accounts for non-oncologic causes and symptoms due to the mass effect on surrounding tissues (vasculature, trachea, and esophagus) is a more comprehensive approach to SVC treatment.