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Maaike Van Gerwen



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    P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.06-35 - Pleurectomy Decortication Versus Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma: SPARCS Data (ID 13265)

      16:45 - 18:00  |  Presenting Author(s): Maaike Van Gerwen

      • Abstract
      • Slides

      Background

      Malignant pleural mesothelioma (MPM) is a rare but grave cancer with poor survival. To date, the debate on the surgery of choice in patients with operable MPM is still ongoing. We evaluated surgery-related mortality and post-operative complications among patients treated with Extrapleural Pneumonectomy (EPP) vs Pleurectomy Decortication (P/D) in the New York Statewide Planning and Research Cooperative System (SPARCS) database.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      SPARCS is an all payer claim database for the State of New York. Data of inpatient stays (1995-2012) were used to extract 3826 unique patients with a diagnosis of MPM (ICD-9-CM: 163 identifying 233 patients treated with EPP (ICD-9-CM codes: 325, 3259) and 267 patients treated with P/D (ICD-9-CM codes: 345, 3451). We used propensity score methods using a logistic regression model matching patients on the following variables: age, race, the presence or absence of comorbidities, type of insurance and type of admission (using 1:1 matching with absolute difference in scores of 0.08).

      4c3880bb027f159e801041b1021e88e8 Result

      There was no difference in the proportion of males between EPP (76.2%) and P/D (80.9%). EPP patients were younger (mean age 60.8 vs 68.6 years), significantly more likely to be white (94.0% vs 85.2%), privately insured (56.6% vs 29.9%) and admitted for an elective procedure (97.9% vs 66.8%) than P/D patients. There were significantly more comorbidities in the EPP group (95.3% vs 85.9%). The in-hospital mortality in the matched patients groups comparing EPP and P/D was higher but not significant [ORadj: 2.82 (95% CI: 0.70-11.38)]. The odds of having postoperative complications was 1.22 (95% CI: 0.68-2.20) when comparing EPP and P/D. Supraventricular arrhythmia as postoperative complication was significantly more frequent after EPP compared to P/D (ORadj: 2.73; 95% CI: 1.14-6.50).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The analysis showed a tendency towards higher odds of in-hospital mortality for EPP versus P/D however not statistically significant. While the odds of postoperative complications were not significantly different between EPP and P/D patients, the odds of supraventricular arrhythmia as postoperative complication were 2.7 times higher after EPP versus P/D. P/D, a less invasive surgical approach, may provide a better option when technically feasible for MPM patients.

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