Author of

• 16935

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  P1.08 - Poster Session with Presenters Present (ID 460)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 2
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16937

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    P1.08-002 - The Prognostic Significance of Pleural Lavage Cytology before and after Lung Resection (ID 3905)

    14:30 - 14:30  |  Author(s): T. Ono
    • Abstract
    • Slides

    Background:
    The status of intraoperative pleural lavage cytology (PLC) has been reported to be a predictive factor of recurrence in resected non-small cell lung cancer (NSCLC). However, prognostic significance of PLC remains unclear and it has not been included in the TNM classification. Furthermore, the appropriate timing to perform PLC, before lung resection (pre-PLC) or after lung resection (post-PLC), is not evident.
    
    Methods:
    Of 627 consecutive patients with NSCLC who underwent complete resection (segmentectomy or more) in Tottori University Hospital from January 2004 to December 2013, 615 patients who were performed both pre-PLC and post-PLC were enrolled in present study. Patients were divided into four groups, negative pre-PLC / negative post-PLC (Group A), positive pre-PLC / negative post-PLC (Group B), negative pre-PLC / positive post-PLC (Group C), and positive pre-PLC / positive post-PLC (Group D). Then differences in recurrence free survival (RFS) and disease specific survival (DSS) among each groups were analyzed by log-rank test. Moreover, PLC status as a prognostic factor for RFS and DSS were analyzed using univariate and multivariate Cox regression models.
    
    Results:
    There were 573 patients in Group A, 11 in Group B, 14 in Group C, and 17 in Group D, respectively. Survival analysis revealed significant differences in not only RFS but also DSS between Group A and Group B (log-rank test, p<0.001), Group A and Group C (p<0.001), Group A and Group D (p<0.001), respectively. However, there was no significant differences among Group B, C, and D (p=0.861). Multivariate analysis identified advanced age (75≤), male sex, larger tumour size (3cm<), lymphnode metastasis, lymphatic invasion, and positive PLC status (Hazard Ratio: 3.735, 95% confidence interval: 2.312 to 6.063, p<0.001) as statistically independent prognostic factors for DSS.
    
    Conclusion:
    In conclusion, positivity of both pre-PLC and post-PLC were significant worse prognostic factor for DSS of patients with completely resected NSCLC. Therefore, surgeons should consider performing PLC both before and after lung resection to estimate patients’ prognosis correctly. Moreover, further accumulation of knowledge about PLC are needed to reflect PLC status in the TNM classification.
    
    

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    P1.08-052 - Comparison Study of Perioperative Outcomes in Robotic, Video-Assisted Thoracic Surgery, and Thoracotomy Approaches for Lung Cancer (ID 5341)

    14:30 - 14:30  |  Author(s): T. Ono
    • Abstract

    Background:
    Robotic surgery for lung cancer has not widely spread because of the lack of definitive advantage compared to conventional approaches, specifically video-assisted thoracic surgery (VATS). Some studies have reported that postoperative complication in robotic surgery is superior for unclear reasons. The aim of this study is to compare the perioperative outcomes, particularly pointing out postoperative complication among robotic, video-assisted thoracic surgery (VATS) and thoracotomy approach in non-small cell lung cancer (NSCLC).
    
    Methods:
    We performed a retrospective review of NSCLC patients who underwent curative anatomical resection in our hospital from January 2011 to April 2016. There were 346 lobectomy cases and 76 segmentectomy cases. The patients were classified into four groups (robotic, VATS, open conversion from VATS, and thoracotomy) and were compared for differences in perioperative outcomes.
    
    Results:
    Total 422 patients (43 robotic, 265 VATS, 30 open conversion from VATS, and 84 thoracotomy) were included in the analysis. Clinical and pathological stage showed earlier in robotic and VATS cases. Operative time (min), bleeding amount (gram) and drainage period (days) for robot, VATS, conversion and thoracotomy were 247/20/2, 188/10/2, 246/100/2, 225/ 92.5/2 respectively(p<0.0001). In the incidence of all, over G3, respiratory over G3 postoperative complications robotic surgery showed significantly lowest among them and there were neither conversion to thoracotomy nor operative/hospital mortality in robotic surgery.
    
    Conclusion:
    In our initial results of robotic surgery, lower incidence of operative morbidities is one of the advantageous features. Important issue whether robotic surgery is established as a minimally invasive approach for NSCLC or not should be verified.