Author of

• 10643

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

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    P1.07-026 - VATS reduces surgical risk of lobectomy for high risk patients with early non-small cell lung cancer (ID 2039)

    09:30 - 16:30  |  Author(s): M. De Valence
    • Abstract

    Background
    Patients considered to be at increased risk from surgery may be offered nonsurgical therapies for early stage non-small cell lung cancer (NSCLC). However, video assisted thoracic surgery (VATS) is associated with lower morbidity and thus may permit anatomic resection for patients considered increased risk.

    Methods
    Our institutional database was queried to find all patients who received lobectomy for early stage NSCLC between 2002-2010. Patients were grouped into cohorts of standard (SR, n=536) or increased risk (IR, n=72) using the ACOSOG Z4099/RTOG 1021 eligibility criteria. Morbidity and mortality were compared based on risk group and surgical method.

    Results
    Median age was 72 and 67 years for IR and SR respectively. Most patients were stage I (IR: 83.3%; SR: 84.5%). Although IR patients had increased overall and pulmonary complications compared to SR (overall: p=0.0004; pulmonary: p<0.0001), there were no differences between the subset of IR patients who had VATS resections and SR patients resected by either open or VATS techniques (overall: p=0.7697; pulmonary: p=0.3219) [Table 1]. Survival at 5 years was significantly lower for IR patients resected by open techniques (46.2%; p=0.0028) but those resected by VATS (61.2%) had similar survival to SR patients resected by either VATS (65.1%) or open techniques (64.3%; p=0.83) [Figure 1]. There was no significant difference in operative mortality between the IR and SR groups (IR: 1.4%; SR: 0.4%; p=0.2832).

    Table 1: Post-operative complications stratified by risk subgroup and surgical method

    	Increased risk (%)	Standard Risk (%)	Increased Risk with VATS resection (%)
    Overall Complications	33.3	16.2	18.2
    Pulmonary Complications	30.6	11.8	18.2

    Figure 1 Figure 1: Overall survival following lobectomy for NSCLC, stratified by risk group and surgical method

    Conclusion
    Surgical morbidity and mortality are reduced in patients at increased risk from lobectomy when resected by VATS offering them equivalent outcomes to standard risk patients.