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)

  • 16945

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    P1.08-010 - Octogenarians Perform Equally to Younger Patients in Lung Cancer Surgery (ID 4653)

    14:30 - 14:30  |  Author(s): M. Fiegl
    • Abstract

    Background:
    Due to prolonged life expectancy, more patients aged 80 years or older will be diagnosed with lung cancer and eventually undergo anatomic lung resection. This study was performed to evaluate outcome in surgically treated octogenarians compared to younger patients.
    
    Methods:
    The institutional database of all consecutive patients treated between 2009 and 2015 was analysed. The age cut-off was set at 80 years. Perioperative and follow-up data were compared between the two groups.
    
    Results:
    A total of 453 patients were treated by a VATS approach at our center for proven NSCLC. 28 (6.2%) patients were aged 80 or older. There was no difference in gender distribution, clinical T stage, preoperative FEV1/FVC and preoperative haemoglobin values. Clinical N stage was higher in the octogenarians (p=0.049). Median operative time was 175 minutes in the younger patients compared to 156 minutes in the octogenarians (p=0.104). Neither tumor diameter nor distribution of tumor histology showed any significant difference between the two groups. Postoperative haemoglobin values as a surrogate parameter for intraoperative complications were comparable between the groups. Median hospital stay was 10 days in both groups (p=0.634). There was no in-hospital mortality in the octogenarians. Disease free (72.1 vs. 58.4 months, p=0.673) and overall survival (81.7 vs. 83.8 months, p=0.456) did not show any significant difference between octogenarians and younger patients. Figure 1
    
    
    
    Conclusion:
    Lung resection can safely be performed in selected octogenarians with acceptable morbidity and low mortality rates. In our experience it is even as safe as in younger patients. Our data adds evidence that in such patients potentially curative treatment should not be withheld.
    
    

  • 16976

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    P1.08-041 - Disease Free and Overall Survival is Equal in Open and VATS Resection for Early Lung Cancer in a Multivariate Analysis (ID 4644)

    14:30 - 14:30  |  Author(s): M. Fiegl
    • Abstract

    Background:
    Video-assisted thoracic surgery (VATS) has become a valid alternative to open resection for lung cancer treatment. However, robust data on the oncologic equality are still missing. This study evaluates disease free and overall survival for patients with early stage (cN0) lung cancer treated either with open or VATS resection.
    
    Methods:
    A total of 359 patients with early stage (cN0) lung cancer with available survival data in our institutional database were treated between 2004 and 2015. VATS was introduced in 2009, since that time all clinically nodal negative patients were treated with an intended VATS approach.
    
    Results:
    There were 198 male patients; median age was 65 (range 38-85) years. 256 (71.3%) patients were treated with a minimally invasive approach. There were significantly more female patients (p=0.002) and lower pT-stages (p=0.002) in the VATS group. Nodal upstaging was found in 19.1% in the VATS group and 23.3% in the open group (p=0.486). 5-year disease free survival was 61.2% in the VATS group and 63.8% in the open group (p=0.492). 5-year overall survival was 84.3% in the VATS group and 73.3% in the open group (p=0.139), Figure 1. In a multivariate analysis including age, gender, pT-status, pN-status and surgical approach, none of the factors proofed to independently predict disease free survival. In overall survival, a positive pN status was found to be the only independent negative prognostic factor (HR: 2.2, 95% CI: 1.2-4.1). Figure 1
    
    
    
    Conclusion:
    Overall and disease free survival are not influenced by the type of surgical approach. Due to perioperative benefits with shorter length of hospital stay and less complications, a minimally invasive approach as the gold standard of surgical treatment for clinically nodal negative lung cancer patients should be advocated.