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R. Davies
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-045 - Evaluation of the Safety and Efficacy of VATS Pneumonectomy in the Treatment of Locally Advanced Lung Cancer (ID 9310)
09:30 - 09:30 | Author(s): R. Davies
- Abstract
Background:
VATS technique has been increasingly used worldwide for the management of lung cancer[1]. VATS lobectomy has been shown to be superior to traditional open lobectomy with shorter length of stay, fewer perioperative complications and improved quality of life[1]. There remain concerns regarding the use of VATS for larger oncological resections including pneumonectomy and sleeve resections. We add more confirmatory data to several retrospective cohort studies demonstrating the safety of VATS pneumonectomy in selected patients[1,2].
Method:
With ethics approval, a retrospective cohort study was performed at a single-centre in Melbourne, Australia. It included all patients who had undergone a pneumonectomy between 1999 and 2017. The primary outcome was overall survival. Secondary outcomes included: 30-day and 90-day mortality, disease free survival and length of stay.
Result:
79 patients underwent pneumonectomy between 1999 and 2017. 27 patients underwent pneumonectomy via VATS approach. There were 76 patients with NSCLC, two with carcinoid and one with melanoma. There was no difference in the tumour size between the two cohorts (VATS median 47mm versus open median 50mm, p=0.12). There was no significance difference in node positive disease between the two cohorts (p=0.14). The 30-day and 90-day mortality rate was 3.8% and 5.1% respectively, with all events occurring in the open cohort. Median overall survival for all patients was 22 months, with a median disease-free survival of 14 months. There was no statistically significant difference in overall survival depending on operative access (median survival VATS 86 months versus open 26.2 months, p=0.12). There was no difference in disease-free survival from NSCLC between the two groups (VATS median 86 months versus open median DFS 15.9 months, p=0.21). The length of stay was shorter in the VATS cohort (7 days versus 8 days, p=0.008). The number of lung cancer cases performed as VATS at our institution has increased from 41% between 2002 and 2011 to 84% since 2014. The rate of VATS pneumonectomy has increased from 18% between 2002 and 2011 to 58.6% since 2014, however this increase lagged three years behind less major resections (i.e. lobectomy).
Conclusion:
In concordance with other recent retrospective cohort studies, our study demonstrates both the safety of VATS pneumonectomy and the oncological efficacy in appropriately selected patients. References: 1. Sahai RK, Nwogu CE, Yendamuri S et al. Is thorascopic pneumonectomy safe? Ann Thorac Surg. 2009;88:1086-1092. 2. Nagai S, Imanishi N, Matsuoka et al. Video-assisted thorascopic pneumonectomy: retrospective outcome analysis of 47 consecutive patients. Ann Thorac Surg. 2014;97(6):1908-1913.
