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Shaohua Xie
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 2
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-04 - Single-Port Video-Assisted Thoracoscopic Surgery Reduces Patient-Reported Symptom Burden in Patients Undergoing Lung Resection (Now Available) (ID 2547)
10:15 - 18:15 | Author(s): Shaohua Xie
- Abstract
Background
Symptom relief has been considered one of the most important targets in recovery from a surgery. This study aimed to evaluate the advantages of single-port video-assisted thoracoscopic surgery (VATS) in reducing postoperative symptom burden, by comparison with multi-port VATS in patients undergoing lung resection.
Method
Data were collected from an ongoing, real-world, multicenter, prospective, observational study initiated in November 2017 (NCT03341377). The MD Anderson Symptom Inventory for lung cancer (MDASI-LC) was administered to assess the severity of postoperative symptoms and their interference with daily functioning preoperatively and daily postoperatively until discharge. A symptom burden index (MDASI-SI) was generated by averaging the top 5 severe symptoms. MDASI-SI was compared between groups using the Wilcoxon rank sum test. The changes of symptoms over hospitalization were compared using mixed modeling.
Result
Among 175 patients who underwent lung resection, 89 underwent single-port VATS, 30 two-port VATS, 13 three-port VATS, and 43 four-port VATS. We combined two- and three-port VATS patients due to the small sample size. The top 5 severe symptoms were pain, fatigue, coughing, disturbed sleep, and shortness of breath for all the patients. There were no significant differences between single-, two/three-, and four-port VATS in preoperative MDASI-SI. The median postoperative hospital stay was 6 days for each group. The MDASI-SI scores of single-port VATS (median=3.6; inter quartile range (IQR)=2.4) were significantly lower than those of two/three-port (median=4.6; IQR=2.8; P=0.043) and four-port VATS (median=5.1; IQR=3.3; P=0.0005) on postoperative day (POD) 1. Compared to four-port VATS, patients who underwent single-port VATS experienced significantly lower symptom burden from POD 1 to POD 6 (estimate=-0.77; SE=0.28; P=0.005).
Conclusion
This study provided real-world evidence that the single-port VATS has a significant benefit of reducing symptom burden in patients undergoing lung resection during the early postoperative period. The long-term benefit and its impact on patient’s quality of life, adjuvant therapy, and survival need to be investigated in further studies.
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P2.16-35 - Factors Associated with Prolonged Postoperative Hospital Stay in Patients Undergoing Lung Cancer Surgery (ID 2489)
10:15 - 18:15 | Author(s): Shaohua Xie
- Abstract
Background
It is important to focus on the risk factors associated with prolonged postoperative hospital stay (PHS) as they can significantly increase medical costs. The study aimed to identify independent risk factors of prolonged PHS in patients who underwent lung cancer surgery.
Method
Data were collected from an ongoing, real-world, multicenter, prospective, observational study (NCT03341377). Inclusion criteria were age 18 years and older, no cognitive impairment and ability to understand the study requirements, pathological primary lung cancer diagnosis, and scheduled surgical procedure. Prolonged PHS was defined as hospitalization for more than 7 days after a lung cancer surgery. Logistic regression was used to identify risk factors of prolonged PHS.
Result
A total of 192 patients (117 males and 75 females) who underwent lung cancer surgery were included. The median PHS was 7 days (range, 2–46 days). Among 192 patients, 64 (33.3%) had prolonged PHS. Among those with PHS, 73.4% were males and patients with a smoking history accounted for 60.9%, Charlson Comorbidity Index scores of >1 for 57.8%, tumor located in the upper lobe for 64.1%, open surgery for 57.8%, lobectomy for 64.1%, systematic lymphadenectomy for 57.8%, and tumor stage ≥Ⅱ accounted for 59.4%. The overall in-hospital complication rate was 25%. The most common complication was prolonged air leak. The multivariate analysis revealed that the surgical approach (open vs. video-assisted thoracoscopic surgery) (OR 2.65, 95% CI 1.05-6.67; P=0.039) and in-hospital complications (no vs. yes) (OR 0.15, 95% CI 0.06-0.35; P<0.001) were independent risk factors of prolonged PHS.
Conclusion
Prolonged PHS is still very common in the real world. Open surgery and in-hospital complications were the two main reasons of prolonged PHS in patients who underwent lung cancer surgery. Further studies with a larger sample size are warranted to confirm our results.
