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Prakash Balakrishnan
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P2.16 - Surgery (ID 717)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.16-028 - Are We Doing the Right Thing? Overall Survival & Intermediate Outcomes Following Lung Metastasectomy (ID 9327)
09:30 - 09:30 | Presenting Author(s): Prakash Balakrishnan
- Abstract
Background:
The ability to constantly metastasize remains a truly challenging obstacle for cancer patients . Historically in the past , any local surgical treatment in patients with systemic malignant disease is considered without any prognostic benefit , this has since evolved with many studies confering huge success rates with excellent prognostic benefits . We hereby report our experience over the last 5 years at Wellington Regional Hospital , Cardiothoracic unit .
Method:
A retrospective study was undertaken in series of cancer patients with colorectal , melanoma , breast , sarcoma & renal metastatic disease undergoing pulmonary metastasectomy , from year 2011 to 2015 . These data was identified & stratified into groups using hospital patient database & ORSOS theatre database
Result:
Total of 61 patients had pulmonary metastatectomies in 5 years , of which 14 were done via VATs wedge resection .Population age between 34 to 86 years old with a M: F ratio of 2:1 . Average age was 63 years . A further 4 patients had multiple metastatectomy on ipsilateral side . 45 patients were non-smoker in this cohort . Average in-hospital stay was 7.83 days , with 3 patients requiring post op ICU admission . 47 patients had pre-op epidural catheter for pain management . Complications include 6 patients needing to return to theatre for suspicion of lung torsion , bronchopleural fistula , haemothorax and 3 patients had torrential air leaks .No major complications noted . Majority had colorectal & melanoma metastases . No mortality at 30 days . 87% survived at 1 year . Total of 38 patients are still alive at present .
Conclusion:
Using MDM as a tool , these carefully selected surgical patients underwent pulmonary metastasectomy for metastatic diseases which confers continual prognostic & survival advantage in this group . Overall 1 year survival seems resonable & surprisingly excellent given the overall bad prognosis of metastatic disease in general .
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-035 - The Unknown: Does Body Mass Index (BMI) Influence Outcomes Post Lung Cancer Resection Surgery? (ID 9307)
09:30 - 09:30 | Presenting Author(s): Prakash Balakrishnan
- Abstract
Background:
Higher BMI is well known to increase the overall intraoperative & post operative surgical risk in obese patients with BMI>30 . Well –published studies have showed that these group of patients have higher affinity for surgical related complications & risks in other surgical specialities , but its impact in patients undergoing pulmonary resections is uncertain. This study looks into this aspect in our cardiothoracic unit .
Method:
A well-conducted retrospective cohort study was performed on all patients undergoing lobectomies for primary lung cancer between year 2011 to 2015 . These data was extracted using the operating theatre ORSOS database and cross referencing with the surgical unit database . Sole exclusion criteria was any patients with BMI<18 . Numerous statistical analysis of demographics & outcomes were tabulated .
Result:
Patient demographics , operation type & side with post operative surgical complications were analysed . Elements of lung function tests were also evaluated
Conclusion:
Identifying the outcomes post lobectomy in patients with BMI>30 will help plan better outstanding and resources for post operative care in this sub group in order to get them thru the post operative course .
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P3.16-036 - Feasibility of Lung Cancer Surgery in Septuagenarians (ID 9317)
09:30 - 09:30 | Presenting Author(s): Prakash Balakrishnan
- Abstract
Background:
Lung Cancer is most common cancer in the world . It has progressively become a disease of older people as radiological & clinical detection improves rapidly with advances in anatomic lung resections . As population grows older demographically , it poses various distinct treatment & management challenges . Thus , we looked into outcomes & factors associated with long-term survival following lung cancer resections in patients older than 70 years of age .
Method:
A retrospective study was conducted , all septuagenarians patients with lung cancer who underwent pulmonary resections , between years 2011 to 2015 , were reviewed . These data was cross-referenced & checked with the operating theatre ORSOS & national mortality data
Result:
80 patients in total . Male predominantly between ages 70 to 79 years old . Average age is 73.5 years . 19 patients were non-smokers . Average in-hosp stay was 9.9 days .5 patients needed post op ICU admission for hypotension & one patient had failed extubation needing prolonged ventilation . 67 patients had epidural catheter for post-op pain management which expedited their pain recovery process . Minor complications includes 6 patients with superficial drain site infection . No one suffered any strokes . No major complications noted . Survival at 30 days – 100% , 1 year – 10 out of 80 patients died - 87.5 % survival rate . At present – 54 out of 80 patients are alive – 67.5 %
Conclusion:
Strict operative patient selection thru MDM will identify groups of patients that will benefit from these surgeries .These group of patients did extremely well post operatively . Important factors associated with these successful surgeries were indicative of the better survival rates. Septuagenarians with lung cancer can be given a new lease of life with continued survivability following major pulmonary resections .
