Author of

• 20165

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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)

  • 22808

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    P1.16-006 - Less Is More: video Assisted Thoracic Surgery (VATS) vs Open Thoracotomy in the Management of Resectable Lung Cancer (ID 8409)

    09:30 - 09:30  |  Author(s): S. Mirshahidi
    • Abstract
    • Slides

    Background:
    Video Assisted Thoracic Surgery (VATS) has become the recommended approach for treatment of early stage lung cancer. No large randomized clinical trial has been conducted to formally compare VATS to open thoracotomy (OT).Our study sought to assess differences in recurrence-free survival (RFS),overall survival (OS),positive margins and postoperative length of stay (LOS) between VATS and OT.
    
    Method:
    A single institution retrospective charts review was conducted for patients diagnosed with stage I-III lung cancer and treated with VATS or OT from May 2005 - May 2015.Patients and tumor characteristics included age at diagnosis, sex, tobacco use, tumor location, stage,size and receipt of chemotherapy or radiotherapy. Chis-square and Wilcoxon-Mann-Whitney tests were used to compare demographic, tumor characteristics and LOS. Multiple logistic and Cox regressions were used to compute relative risk (RR) for positive margins and mortality hazards ratio along with 95 percent confidence interval limits (95%CI), respectively.
    
    Result:
    A total of 235 patients underwent lung resection for cancer diagnosis; VATS n = 101 and OT n = 134. Age at diagnosis, sex, tobacco use, tumor location,and size were comparable for VATS and OT. No significant difference was observed in the risk of positive margins for VATS versus OT [RR= 0.56 (95%CI= 0.26, 1.05)]. However,VATS (4 days) had shorter median LOS compared to OT (6 days), P=0.002.Recurrence [HR= 1.21 (95%CI= 0.74, 2.00)] and mortality hazards [HR= 1.34 (95%CI= 0.88, 2.06)] were comparable for VATS versus OT,with consistent results observed for analysis limited to subjects having negative margins and across tumor stage at diagnosis. Figure 1
    
    
    
    Conclusion:
    Our results show that compared to OT, VATS leads to shorter LOS while achieving comparable margins status, recurrence-free and overall survival regardless of tumor stage at diagnosis. By reducing LOS, VATS is cost effective while achieving similar outcomes and should be considered as the approach of choice for patients undergoing lung resection for cancer.
    
    

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