Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
surgically treated octogenarians compared to younger patients. Methods:
The institutional database of all consecutive patients treated between 2009
and 2015 was analysed. The age cut-off was set at 80 years. Perioperative
and follow-up data were compared between the two groups. Results: A total
of 453 patients were treated by a VATS approach at our center for proven
NSCLC. 28 (6.2%) patients were aged 80 or older. There was no difference in
gender distribution, clinical T stage, preoperative FEV1/FVC and preoperative
haemoglobin values. Clinical N stage was higher in the octogenarians
(p=0.049). Median operative time was 175 minutes in the younger patients
compared to 156 minutes in the octogenarians (p=0.104). Neither tumor
diameter nor distribution of tumor histology showed any significant
difference between the two groups. Postoperative haemoglobin values as
a surrogate parameter for intraoperative complications were comparable
between the groups. Median hospital stay was 10 days in both groups
(p=0.634). There was no in-hospital mortality in the octogenarians. Disease
free (72.1 vs. 58.4 months, p=0.673) and overall survival (81.7 vs. 83.8 months,
p=0.456) did not show any significant difference between octogenarians and
younger patients.
or over have been increasing in the aging society, which are accounted for
approximately 10% in Japan. Due to the prolonged life expectancy in the
elderly, it is inevitable to assess the feasibility of pulmonary resection for
lung cancer especially in patients over 85 years in age. Methods: From 1995
to 2015, we underwent 3,099 pulmonary resections for lung cancers in our
department. Among them, 213 (6.8%) were aged 80 years or older. They were
divided into 2 groups based on the age, i.e., “Over80” who were aged from 80
to 84 and “Over85” who were aged 85 or elder. Clinicopathological factors
were analyzed between these two groups, using the t-test or the Chi-squared
test. Survivals were calculated by Kaplan-Meier estimation methods. Results:
Of the cases, 174 (84%) showed Over80 and 39 (18%) showed Over85. The
proportions for male, comorbidity rate, c-stage I disease in the Over85 group
were not significantly different than those of the Over80 group (age; 20 (51%)
vs. 105 (60%), p=0.189: comorbidity; 36 (92%) vs. 154 (89%), p=0.489: c-stage I;
36 (92%) vs. 143 (82%), p=0.119). The surgical candidates of the octogenarian
included 167 (78%) radiological pure-solid lung cancer, however, there was
not significant difference between the 2 groups (28 (72%) vs. 139 (80%),
p=0.267). Lobectomy was equally performed in 28 (72%) on the Over85 and
126 (72%) of the Over80 (p=0.938), respectively. Perioperative morbidities
were observed in 104 (48%) of the patients, though, significant difference
was not found between the two study arms (84 (48%) vs. 20 (51%), p=0.734)
and the 30-day mortality rates was observed just one patient for the Over80
group. The 5-year overall survival was 51.1% in the Over80 group, 62.6% in
the Over85 group (p=0.275), respectively. Conclusion: In the octogenarians,
a patient with radiological pure-solid lung cancer was more common as a
surgical candidate for the definitive local management. Although proper
patient selection and meticulous perioperative management were mandatory
for surgical resection of the very elderly, our results support the finding that
radical surgical intervention could be feasible even for the patients with high
age over 85 years.
Keywords: Pulmonary resections for lung cancer in patients aged 80 years or
over
POSTER SESSION 1 - P1.08: SURGERY
RISK ASSESSMENT & PROGNOSTIC FACTORS –
MONDAY, DECEMBER 5, 2016
P1.08-012 CHARACTERIZING TIME TO CARE FOR LUNG CANCER
SURGICAL PATIENTS
Breanne Cadham 1 , Janine Olsen 2 , Rasika Rajapakshe 2 , Michael Humer 3
1 BC Cancer Agency, Kelowna/Canada, 2 BC Cancer Agency, Kelowna/BC/Canada,
3 Kelowna Thoracic Surgical Group, Kelowna/BC/Canada
Conclusion: Lung resection can safely be performed in selected octogenarians
with acceptable morbidity and low mortality rates. In our experience it is even
as safe as in younger patients. Our data adds evidence that in such patients
potentially curative treatment should not be withheld.
Keywords: octogenarians, VATS
POSTER SESSION 1 - P1.08: SURGERY
RISK ASSESSMENT & PROGNOSTIC FACTORS –
MONDAY, DECEMBER 5, 2016
P1.08-011 FEASIBILITY OF SURGICAL RESECTION FOR LUNG
CANCER PATIENTS AGED OVER 85 YEARS
Takehiro Ouchi, Aritoshi Hattori, Takeshi Takeshi Matsunaga, Kazuya
Takamochi, Shiaki Oh, Kenji Suzuki
General Thoracic Surgery, Juntendo University, Tokyo/Japan
Background: The Kelowna Thoracic Surgical Group (KTSG), centered in
Kelowna, British Columbia (BC), Canada provides care to a geographic area of
807,538 km 2 . This is 85% of the province of BC and approximately 9 times the
size of Austria. A significant portion of this population consists of remote and
rural communities. Ensuring equal and prompt access to lung cancer diagnosis
and treatment regardless of proximity to treatment center is important not
only because of the time sensitivity of care, but also because of the overall
healthcare burden of this highly prevalent and often lethal malignancy.
Methods: A retrospective chart review was performed on all patients seen
by the KTSG who came to definitive surgical treatment in Kelowna for a
diagnosed or suspected lung cancer between January 2010 and December
2015. Dates were collected at three time-points along the care pathway:
Referral, Consult, and Surgical Treatment. We calculated times from referral
to consult (RC), consult to treatment (CT), and overall referral to treatment
(RT). Demographic information was collected for each of the patients and
the distances patients’ lived from the Surgical Centre were determined. The
study has received approval from both University of British Columbia – BC
Cancer Agency and Interior Health Authority research ethics boards. Results:
There were 902 patients in the cohort; 446 local patients who lived within a
radius of 100 km or less from Kelowna and 456 distant patients who resided
further than 100 km from the city. For the entire group, the median RT was
50.5 days comprised of RC = 6 days, and CT = 42 days. For the local patient
group, the median RT was 49 (Interquartile Range (IQR) = 33.75 to 69) days
compared to a median of 52.5 (IQR = 36 to 52.5) days for the distant patients.
The extreme overlap in the IQR shows no significant clinical difference in time
to care between the local and distant patients. Conclusion: Time from referral
to treatment for patients with suspected or confirmed lung cancer seen by
the IHTSG is similar for both local and distant patients. The equitable times
to care with the IHTSG suggests that the current model of patient-doctor
communication provides a growing opportunity to mitigate the impact of
distance on access to care.
Keywords: Health Equity, Thoracic Surgery, Time to Care
Background: Pulmonary resections for lung cancer in patients aged 80 years
Copyright © 2016 by the International Association for the Study of Lung Cancer
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