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A. Vigo
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-020 - Unequal Access to Health Care System Have a Higher Impact in Upgrading Staging for 8th TNM Ed (ID 10239)
09:30 - 09:30 | Author(s): A. Vigo
- Abstract
Background:
Lung cancer is the leading worldwide cancer related death. Recently, 8[th]edTNM lung cancer was published, changing prognosis. Brazil provides free public healthcare system(SUS); however, we believe access is unequal. 25% of population has private healthcare insurance(SHS). Our objective was to evaluate the impact of the new staging and overall survival comparing patients from SUS and SHS.
Method:
Restrospective analysis of primary lung cancer patients resected between 2011 and 2016. Pathological was classificated according to 8[th]ed TNM. Proportional odds model was used to compare staging and healthcare system,Kaplan-Meier and Log-Rank test for survival analysis.
Result:
267 patients underwent surgery for lung cancer. 52.6%(139)were females, 64.5yo(SD=10.06), adenocarcinoma(60.7%) and 61%(163)from SUS. The upgrade in staging for the current system(8[th]) was significantly higher for SUS(graphic 1)(OD1.55– 95%CI1.00-2.39). Overall median survival was 61months regardless staging, with SHS better survival(p=0.080),graphic 2.Figure 1Figure 2
Conclusion:
Lung cancer new staging is more precise predicting prognosis. An upstaging was expected with new TNM classification. However, a patient from SUS has a 55% higher chance than private care patients of being upstaged not only in T descriptor but also in final staging TNM. Also, SUS had a lower survival tendency. We need to review and address our unequal healthcare system in order better assist our patients.
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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-028 - Is Video-Assisted Thoracic Surgery a Safer Procedure for Lung Cancer Patients? (ID 10442)
09:30 - 09:30 | Author(s): A. Vigo
- Abstract
Background:
Video-assisted anatomical lung resections(VATS) have been increasingly performed worldwide for lung cancer with excellent results. Nonetheless, no comparative analysis has been done in Latin America where we find a different mix of cases when compared to the US or Europe. The purpose of this study was to compare the outcomes of VATS versus open thoracotomy (OT) for anatomical lung resection in patients from the Brazilian Society of Thoracic Surgery (BSTS) database.
Method:
This study was a propensity score analysis of 728 lung cancer patients who underwent anatomic lung resections (358 thoracotomies and 370 VATS) registered in the BSTS database from its inception in August 2015 until May 2017. Pneumonectomies were excluded for analisis purposis A propensity-score model was built using the following baseline characteristics: age at surgery, gender, BMI, comorbidities, type of resection, staging. The main outcomes were mortality, complications and major cardiopulmonary complications.
Result:
Overall in hospital mortality was significant higher in OT(3.6%) in comparison to VATS(0.8%) (OD=4.75, 95%CI=1.28-17.62). Major cardiopulmonary complications were more frequent in patients who underwent OT (17.3%) in comparison to VATS (13%) (OR=1.32; 95%CI:0.85-2.05), but not significant. When analyzing all complications, both technics were similar (OD=1.08, 95%CI0.77-1.51). Figure 1
Conclusion:
In Brazil, minimally invasive surgery (VATS) for anatomic lung resections is associated with a significantly lower rate of mortality when compared to conventional thoracotomy.
