Author of

• 25914

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  MA23 - Early Stage Lung Cancer: Present and Future (ID 926)

  • Event: WCLC 2018
  • Type: Mini Oral Abstract Session
  • Track: Treatment of Early Stage/Localized Disease
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 10:30 - 12:00, Room 105

  • 26164

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    MA23.09 - Minimally Invasive Approaches Do Not Compromise Outcomes for Pneumonectomy, a Comparison Utilizing the National Cancer Database (ID 12073)

    11:30 - 11:35  |  Author(s): Todd Demmy
    • Abstract
    • Presentation
    • Slides

    Background
    

    Minimally invasive approaches are increasingly being used for the conduct of complex surgical procedures. Whether the benefits of minimally invasive approaches compared to thoracotomy for sublobar and lobar lung resection for nonsmall cell lung carcinoma are realized for patients undergoing pneumonectomy is not clear.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    The National Cancer Database was queried for patients who underwent pneumonectomy for NSCLC from 2010-2014. Those who underwent resection by a minimally invasive approach (MIS) were compared with those who were done by thoracotomy (Open) in an intent-to-treat analysis. Associations between potential covariates and treatment were analyzed using the Pearson Chi-square test for categorical variables and Wilcoxon Rank Sum test for continuous variables. Univariable and multivariable logistic models and proportional hazards model were used to assess the effect of surgical approach on 30 day and 90 day mortality and overall survival. Relative prognosis was summarized using odds ratios (OR) and hazards ratios (HR) estimates and 95% confidence limits.

    4c3880bb027f159e801041b1021e88e8 Result
    

    A total of 4,938 patients underwent pneumonectomy during the study period, of which 755 (15.3%) were completed by minimally invasive approaches (MIS). No difference was noted in 30 and 90-day mortality rates for MIS compared to Open approaches (6.8% and 12.3% vs 6.7% and 11.9% respectively, p = 0.9 and 0.86). Tumor histology and stage characteristics were similar between the two groups. Mean lymph nodes examined was higher in the MIS group compared to Open (17.1± 0.4 vs 16.1 ± 0.2, p=0.034). Surgical approach was not associated with any difference in perioperative mortality with univariable or multivariable analysis. MIS was associated with improved overall survival on univariable analysis, but this was not evident with multivariable analysis.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Pneumonectomy performed by minimally invasive approaches does not compromise perioperative mortality or long term outcomes. Further investigation into the impact of minimally invasive approaches on perioperative outcomes for whole lung resection is warranted.

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