Author of

• 13794

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  P1.10 - Poster Session/ Advocacy (ID 228)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Advocacy
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 13801

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    P1.10-007 - Impact of Intensive Interprofessional Perioperative Management on Clinical Outcome in the Elderly Patients with Lung Cancer Surgery (ID 1564)

    09:30 - 09:30  |  Author(s): H. Torigoe
    • Abstract

    Background:
    Perioperative assessment and care, such as enhanced recovery after surgery(ERAS), are important to improve clinical outcome in the patient who receive surgery. Standard therapy for the patients with clinical stage I non-small-cell lung carcinoma (NSCLC) is radical surgery. However, the elderly patients often suffer from several comorbidities, poor performance status (PS) and/or poor respitary/motor function, causing high incidence of postoperative complication and resulting in a limited resection or other alternative therapy. In September 2008, our hospital launched a perioperative management center (PERIO) to improve perioperative management and clinical outcome of patient receiving surgery, which was organized with dedicated　nurses, anesthesiologists, dentists, physiotherapists, pharmacist and nutritionist. All patients, not only elderly patients, who are scheduled to receive thoracic surgery present to PERIO center which perform intensive perioperative assessment and care with interprofessional collaboration consistently from before hospitalization until discharge after surgery. In this study, we investigated the impact of introduction of PERIO on clinical outcome in the elderly patients who received thoracic surgery due to clinical stage I NSCLC.
    
    Methods:
    Ninety-one elderly patients (over 80 years old) who received pulmonary resection were enrolled in this study. We excluded patients harboring ground glass opacity-dominant tumor in the diameter less than 2cm because of high curative rate even if it is treated with limited resection. We categorized those patients into non-PERIO group among January 2000 to August 2008 (n = 42) and PERIO group among September 2008 to November 2014 (n = 49). We compared perioperative factors between the two groups.
    
    Results:
    The median age, PS (0-1 / 2-4) and median FEV1.0 were 81.5 vs 82.0 years old, 38/4 vs 42/7, 1.9L vs 1.8L in non-PERIO and PERIO groups, respectively. The patient with comorbidity were significantly more frequent in PERIO group (75.5%) than non-PERIO group (52.4%, P =0.025 ). Although the radical surgery (lobectomy or segmentectomy with systemic lymph node dissection) were more frequently performed in PERIO group (75.5%) than non-PERIO group (52.4%, P =0.022 ), there was no significant difference in the incidence of postoperative complication ( 24.4% and 28.6% in non-PERIO and PERIO groups, respectively) and post-operative hospital days (median 15 days in both group) in both groups.
    
    Conclusion:
    Radical surgery was more frequently performed after introduction of PERIO without increase of postoperative complication rate and hospital days, suggesting that PERIO may play an important role to improve perioperative clinical outcome in elderly patients treated with thoracic surgery.