Virtual Library
Start Your Search
Robert Dziedzic
Author of
-
+
EP1.07 - Nursing and Allied Professionals (ID 197)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Nursing and Allied Professionals
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.07-03 - Preparedness in Promoting and Self-Assessment of Nurses Ability to Promote Health Awareness in Lung Cancer Prevention (Now Available) (ID 640)
08:00 - 18:00 | Author(s): Robert Dziedzic
- Abstract
Background
Aim: The aim of this study was to analyze the self-assessment of nurses’ knowledge regarding lung cancer, and to verify whether this group of professionals is prepared for promoting lung cancer prevention.
Background: Lung cancer constitutes a health and epidemiological problem worldwide.
Introduction: The complete elimination of exposure to the components of tobacco smoke is a primary prevention component of vital importance and should constitute extensive educational activities be undertaken by family nurses. However, according to available literature, the level of relevant knowledge represented by nurses remains insufficient.
Method
This study included 490 nurses from Pomerania province. All the respondents completed the questionnaire verifying their knowledge of the etiology of lung cancer and their preparedness for promoting the prevention of this malignancy and self-assessed knowledge of the problems in question.
Result
The average level of etiological knowledge of lung cancer was high. Preparedness for promoting health awareness in the prevention of lung cancer represented an intermediate level.
The efficacy of screening is determined by its coverage. Nurses can provide a pivotal role in lung cancer prevention provided they are given training and responsibility for these additional duties.
Conclusion
Many nurses, given appropriate training, have the potential for educating people in the prevention of lung cancer. However, full utilization requires education and reorientation of nurses towards primary prevention, especially in healthcare education.
Nursing professionals may require additional training and increases in staffing to adequately respond to the increase in responsibility for patient care.
Implications highlight a need for additional training and consultancy to improve knowledge and preparedness of nurses to address concerns in lung cancer prevention.
-
+
EP1.17 - Treatment of Early Stage/Localized Disease (ID 207)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.17-04 - Pneumonectomy Should Be Avoided in Patients Who Do Not Reach the Distance of 500 Meters in 6-Minute Walking Test Due to High Early Mortality (Now Available) (ID 1125)
08:00 - 18:00 | Author(s): Robert Dziedzic
- Abstract
Background
Pneumonectomy is required in less than 10% of patients operated for lung cancer. This type of surgery is performed ultimately because of its debilitating character, high morbidity, and mortality. Previously estimated values of the 6-minute walking test (6MWT) performed preoperatively helps to identify high risk of postoperative complications, increased early mortality and worse long term results in patients undergoing lobectomy for lung cancer. The aim of the study was to validate the value of 500 meters in 6MWT differentiating risk of complications in patients undergoing pneumonectomy.
Method
Between January 2009 and January 2018 1618 patients were operated in the Thoracic Surgery Department. All of the patients were accepted for resection based on a standard evaluation protocol. Additionally, on the day before the surgery, patients performed 6MWT. 141 patients underwent pneumonectomy, but 16 patients did not undergo 6MWT due to different reasons. Finally, 125 patients entered the analysis. The cut-off value of 6MWT – 500 meters was defined in previously published papers in patients requiring lobectomy. This value was validated in the current study in patients who underwent pneumonectomy.
Result
There were 93 men and 32 women with a mean age of 63 years. All patients underwent pneumonectomies due to primary lung cancer. The cut-off value of 500 meters identified patients with increased 90-day mortality [17.9% vs. 3.5% odds ratio (OR) 6.271 95% confidence interval (CI) 1.528-25.739 p=0.005], and first-year mortality (30.7% vs. 11.6% OR 3.378 95%CI 1.310-8.709 p=0.009), while 30-day mortality (10.3% vs. 2.3% OR 4.800 95%CI 0.840-27.418 p=0.055) fairly reached statistical significance. Patients who covered distance shorter than 500 meters had increased risk of atrial fibrillation (35.9% vs. 16.3% OR 2.880 95%CI 1.207-6.870 p=0.015) and cardiac complications (38.4% vs. 19.8% OR 2.537 95%CI 1.100-5.849 p=0.026). The rates of pulmonary complications, general complications, and duration of postoperative stay did not differ between the study populations.
Conclusion
Patients who do not reach the distance of 500 meters in 6MWT have a high risk of cardiac complications and early postoperative death after pneumonectomy.
-
+
P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
-
+
P1.11-08 - Are Risk Prediction Models Superior Over Standard Criteria for Lung Cancer Screening in Europe? Macroscale Simulation on Large Polish Cohort (ID 1911)
09:45 - 18:00 | Author(s): Robert Dziedzic
- Abstract
Background
Inauguration of the national lung cancer screening programme in Poland is to take place in 2019. Yet, issues such as optimal selection criteria remain unresolved. A computational macroscale simulation of lung cancer risk prediction models’ implementation and comparison in a large lung cancer screening cohort of 5,534 individuals from a single, experienced European center was performed.
Method
A total of 5,534 healthy volunteers (aged 50-79, smoking history ≥30 pack-years) were enrolled in the Moltest Bis Programme (Moltest) between 2016 and 2017. Inclusion criteria were based on the Lung Cancer Screening National Comprehensive Cancer Network Clinical Practice Guidelines. Each participant underwent a low-dose computed chest tomography scan and selected participants underwent a further, diagnostic work-up. A computational macroscale simulation of Tammemagi PLCOm2012, Liverpool Lung Project (LLP) and Bach risk models’ implementation was applied. Jupyter notebook v.1.0 scientific environment was used to calculate lung cancer probability of all Moltest participants. Patients i) with 6-year lung cancer probability ≥1.3% were considered as high risk in PLCOm2012 model, ii) in LLP model with 5-year lung cancer probability ≥5.0%, and iii) in Bach model with 1-year lung cancer probability ≥2.0%. Such selected patients were eligible for the inclusion to the simulated lung cancer screening programme. Boolean functions were created and data frames containing patients’ epidemiological characteristics were joined using Pandas Python Library v.0.23 for Python v.3.7.
Result
In a computational macroscale simulation 3,897 (70.4%), 3,118 (56.3%) and 925 (16.7%) out of 5,534 Moltest participants met the threshold criteria of lung cancer probability in PLCOm2012, LLP and Bach models, respectively. With 199 (3.6%) Moltest individuals initially referred for diagnostic work-up in the programme, lung cancer was confirmed in 105 (1.9%) cases. Contrarily, among high-risk individuals selected based on PLCOm2012, LLP and Bach models, respectively, 103 (2.6%), 56 (1.8%) and 24 (2.6%) constituted the lung cancer cases primarily detected in the Moltest programme. Thus, in PLCOm2012, LLP and Bach models the proportions of screen-detected lung cancer cases were 98.1%, 53.3% and 22.9%, respectively.
Conclusion
Risk prediction models provide a vast disparity in selecting lung cancer high-risk individuals. Lung cancer screening enrollment based on Tammemagi’s PLCOm2012 risk prediction model is superior over LLP, Bach models and standard selection criteria based on age and pack-years.
-
+
P1.17 - Treatment of Early Stage/Localized Disease (ID 188)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
-
+
P1.17-31 - VATS Segmentectomies Are at Least as Safe as VATS Lobectomies (Now Available) (ID 1453)
09:45 - 18:00 | Author(s): Robert Dziedzic
- Abstract
Background
Video-assisted thoracic surgery (VATS) segmentectomy is a feasible and effective treatment of not only benign lung tumors but also non-small cell lung cancer (NSCLC). Expanding the indications for surgical treatment of early NSCLC in high-risk patients may result in an increased number of complications in the postoperative period.
Method
Between January 2018 and December 2018 22 VATS segmentectomies were performed in a single center. The postoperative period was recorded and these data were compared to postoperative results of 31 patients who underwent VATS wedge excisions in the relevant period and 438 VATS lobectomies during the VATS program in the department. In order to assess the influence of the type of resection on the number of postoperative complications, multivariable analysis was performed. The selection biases were reduced by the use of propensity-score matched analysis (PSMA; using the nearest neighbor matching method by age, gender, Charlson Comorbidity Index [CCI] and 6-minute walking distance).
Result
In the multivariable analysis, CCI was the only independent risk factor of increased complications rate (HR 1.321 95%CI 1.009-1.730 p=0.042). Type of resection, gender, and 6-minute walking distance did not influence the risk of complications. The rate of complications in patients who underwent VATS wedge excision was 12.9%, VATS segmentectomies 27.2% and VATS lobectomies 51.5% (OR 2.846 95%CI 1.021-8.298 p=0.026 segmentectomies vs. lobectomies). However, in PSMA analysis, there was a trend towards lower complications rate in patients who underwent VATS segmentectomy comparing to VATS lobectomies (30% vs. 60% OR 0.286 95%CI 0.061-1.263 p=0.057). Postoperative hospital stay did not differ between the study groups 4 vs. 5 days (p=0.170).
Conclusion
VATS segmentectomy is characterized by similar complications rate and postoperative hospital stay if compared with VATS lobectomy.
