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R.M. Terra
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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): R.M. Terra
- 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.
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P2.13 - Radiology/Staging/Screening (ID 714)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.13-022 - Lung Nodule Survey: One Pathology, Perspectives from Thoracic Surgeon, Pulmonologist and Radiology Point of View (ID 10408)
09:30 - 09:30 | Author(s): R.M. Terra
- Abstract
Background:
Screening program for lung cancer are leading for more incidental lung nodules diagnosis.This study aimed to address the lung nodule management from different specialty perspective working in different settings. This is the first survey uniting national societies in Brazil and in Latin America.
Method:
A web-based survey was developed by thoracic surgeons, pulmonologists and radiologists to evaluate lung nodule perception and management. This survey was sent to their respective national societies members and answers collected between August and December 2016. That included multiple choice questions regarding age, specialty, lung nodule management, accessibility to exams and interventional procedures characterizing public (SUS) and supplementary(SHS) working settings.
Result:
A total of 461 questionnaires were answered. More than half of participants live in cities with over one million population. Specialties were reasonable equilibrated with 43.5% radiologists, 33.5% thoracic surgeons, 20.3% pulmonologist and 2.6% others. Most of the respondents work in both public and private sector (72.7%). SHS has a similar reality compared to well developed nations regarding exams accessibility and interventions. SUS setting has a significant difference according to the participants. CT is only easily available in 31.9% of cases, PET-CT is easily available in 24.4%(graphic1), bronchoscopy is unavailable and almost unavailable for 33.1%, IR biopsy is unavailable in 38.2% and video-assisted thoracic surgery (VATS) biopsy is easily available in 42.8%. When there is a probability of malignancy of 50% or higher, 46.5% of participants would be comfortable recommending surgical biopsy. When the probability higher than 10%, only 36.9% would be comfortable following up radiologically. Figure 1
Conclusion:
Brazil has a very different setting for SUS and SHS patients regarding exams availability and management options. That might explain why participants have a higher tendency to choose interventional diagnosis and explains why current guidelines may not be applicable to developing countries reality.
