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Guanping Qiu



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    P1.01 - Advanced NSCLC (ID 158)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.01-131 - The Comparison Between Non-Intubated and Intubated Anesthesia Video-Assisted Thoracoscopic Surgery: A Meta-Analysis (ID 3118)

      09:45 - 18:00  |  Presenting Author(s): Guanping Qiu

      • Abstract

      Background

      It remains unclear whether the feasibility and safety of non-intubated VATS under LA is comparable or advantageous compared with conventionally intubated VATS under GA in different thoracic diseases. Consequently, a meta-analysis was conducted with the aim of assessing whether non-intubated VATS offered better perioperative outcomes over intubated VATS in terms of diverse thoracic diseases, including pulmonary nodules, spontaneous pneumothorax, and malignant pleural effusion.

      Method

      A comprehensive search of online databases was performed. Intraoperative and postoperative variables were compared between the subgroups. The odds ratio (OR) or SMD and its 95% CI was calculated using a random effects model. Heterogeneity across studies was examined by the Cochran Q chi-square test and the I² statistic.

      Result

      A total of 15 eligible studies including 1964 patients were recruited. Each included study had comparable baseline characteristics and the same surgical procedures except for the regimens of anesthesia and ventilation. Non-intubated anesthesia VATS was performed on 959 patients, whereas the other 1005 patients underwent intubated VATS. In the overall analysis, patients who underwent non-intubated surgery associated with significant shorter postoperative hospital stays (SMD=-0.36, p<0.001), postoperative fasting time (SMD=-2.80, p<0.001) and anesthesia time as well as lower rates of mortality, postoperative overall, respiratory, and cardiovascular complications. Patients underwent non-intubated surgery also manifested a trend toward shorter operative time and less blood loss with no significant significance.

      Conclusion

      Non-intubated VATS was confirmed as a safe and feasible alternative to intubated VATS and potentially provided a more rapid postoperative rehabilitation than intubated VATS overall and specifically in the management of pulmonary nodules, spontaneous pneumothorax, and malignant pleural effusion. Future large-scale multicenter studies are supposed to focus on prospective validation of feasibility and safety and immunological changes for non-intubated thoracoscopic approach

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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-32 - The Impact of Segmentectomy Versus Lobectomy on Pulmonary Function of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis (ID 1681)

      10:15 - 18:15  |  Presenting Author(s): Guanping Qiu

      • Abstract

      Background

      Lobectomy with lymph node dissection is considered the standard surgical procedure for non-small cell lung cancer (NSCLC). Recently segmentectomy has been regarded as an alternative in early peripheral NSCLC owing to its theoretical advantages of lung function preservation. However, Segmentectomy presents some oncological risk. Thus, we performed a meta-analysis with the aim of evaluating whether segmentectomy offers an advantage in lung function preservation compared with lobectomy.

      Method

      We searched and retrieved studies from four databases. Postoperative results and lung functional index and were synthesized. The odds ratio (OR) or Standard Mean Difference (SMD) and its 95% CI were calculated using a random effects model. Subgroup division was conducted according to different time points. Single-arm meta-analysis for lung function of each visit time was conducted. Repeated-measures analysis of variance (ANOVA) was used to compare the lung function between each visit.

      Result

      A total of 16 eligible studies including 6,098 patients were recruited. Two groups showed no significant difference based on baseline characteristics before surgery between groups (Segmentectomy and Lobectomy). Segmentectomy correlated with a greater postoperative preserved pulmonary function than Lobectomy in FVC (SMD=0.23, p=0.009) and FEV1 (SMD=0.27, p=0.002), especially within 12 months after surgery. ANOVA showed no difference between FVC (p=0.647) and FEV1 (p=0.468) of the two groups according to visit time. The segmentectomy group showed no significant difference of postoperative complications compared with the Lobectomy groups(OR=0.95, p=0.618) and the recurrence rates were similar between groups (OR=0.90, p=0.644).

      Conclusion

      Segmentectomy offers a better short-term but similar long-term lung functional preservation compared with Lobectomy, with similar surgical and oncological safety.

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    P2.09 - Pathology (ID 174)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Pathology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.09-04 - The Clinicopathological Characteristics and Prognosis of Lung Cancer with Tumor Spread Through Air Spaces: A Meta-Analysis (Now Available) (ID 1652)

      10:15 - 18:15  |  Author(s): Guanping Qiu

      • Abstract
      • Slides

      Background

      Background: The clinicopathological characteristics of lung cancer with tumor spread through air spaces (STAS) has not been clearly characterized yet. Also, it is still not clear whether the presence of STAS correlated with worse prognosis in patients with lung cancer. Thus, we aim to systematically evaluate the clinicopathological characteristics and prognosis of the patients with or without STAS undergoing surgical resection for lung cancer.

      Method

      Materials and Methods: A comprehensive search of online databases was performed. Clinicopathological characteristics, 5-year RFS and OS rate were compared between 2 groups. Cumulative meta-analysis was performed to evaluate the temporal trend of pooled outcomes. Specific subgroups according to different types of lung cancer are examined.

      Result

      Results: A total of 25 eligible studies including 8494 patients were recruited. STAS occurred in 2881 patients (34%) while non-STAS occurred in 5613 patients (66%). Overall, patients with STAS manifested significantly more aggressive characteristics, including lymphatic invasion (SMD=2.935; P=0.000), pleural invasion (SMD=2.329; P=0.000), vascular invasion (SMD=2.306; P=0.000) as well as lymph node metastasis (OR=3.510; P=0.000). Patients with STAS also correlated with significantly higher pathological stage (OR=2.216; P=0.003), T stage (OR=1.756; P=0.000), N stage (OR=2.395; P=0.000) and larger tumor size (OR=0.275; P=0.001). Meanwhile, the incidence of STAS was significantly associated with the micropapillary (OR=9.792; P=0.000) and solid patterns (OR=2.451; P=0.000). Moreover, the presence of STAS was related to male sex (OR=1.493; P=0.000), smoking history (OR=1.637; P=0.000) and necrosis (OR=2.300; P=0.000). As for the outcomes of the prognosis, patients with STAS linked with significant worse prognosis than those without STAS, including both 5-year RFS (HR=0.585; 95% CI: 0.486–0.684; P=0.000) and 5-year OS rate (HR=0.788; 95% CI: 0.596–0.980; P=0.000).

      Conclusion

      Conclusions: The presence of STAS was associated with several invasive pathological characteristics, which might explain the worse prognosis in patients with STAS compared with those without STAS.

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