Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
chronic renal disease. As for tumour types, the majority was adenocarcinoma
(34), followed by squamous cell (18), carcinoid tumour (3), SCLC (1),
adenosquamous (1) and poorly differentiated lung cancer (1). One patient had
2 synchronous tumours and two patients developed a new type of tumour
during follow-up. As for staging, the majority of patients were in clinical stage
IA (20) and the rest distributed as follows: IB - 13 pts, IIA - 4 pts, IIB - 4 pts,
IIIA - 10 pts, IIIB - 1 pt and IV - 6 pts. At the time of pathological staging 1 was
up-staged and 1 down-staged. In stage IV patients, 4 surgeries were performed
with paliative intent and 2 with curative intent. In 17.2% patients was given
neo-adjuvant chemotherapy, and 44.8% received adjvant chemotherapy.
We performed 64 surgeries (41 lobectomies with lymphadenectomy (11
VATS); 6 bilobectomies; 3 pneumectomies; 6 wedge resections; 1 exploratory
thoracotomy and 3 mediastinoscopies. Results: There was no perioperative
mortality. Eight patients had major complications (6 - post-operative
pneumonia). The mean follow-up time was 21+11 months with an overall
mortality of 15.5%. Stage related mortality: for stages IA and IB the overall
survival was 100% with mean follow-up time of 23 months, in stage IIA the
overall survival was 83.4% with mean follow-up time of 28 months, in stage
IIB the overall survival was 75% with mean follow-up time of 24 months, in
stage IIIA the overall survival was 70% with mean follow-up time of 20 months
and in stage IV the overall survival was 33.3% with mean follow-up time of 18
months. Conclusion: These outcomes overlap those reported in recent data
from the literature. Although our Hospital is a low/medium volume centre for
Lung Cancer we show with these data that with a dedicated multidisciplinary
team it is possible to replicate the international results.
Keywords: Surgery, outcomes, new hospital
POSTER SESSION 1 - P1.08: SURGERY
EPIDEMIOLOGIC STUDIES IN SURGERY FOR NSCLC –
MONDAY, DECEMBER 5, 2016
P1.08-027 EVOLUTION OF SURVIVAL IN A REGIONAL POPULATION-
BASED US LUNG CANCER RESECTION COHORT
Raymond Osarogiagbon 1 , Nicholas Faris 1 , Matthew Smeltzer 2 , Meredith
Ray 2 , Carrie Fehnel 1 , Cheryl Houston-Harris 1 , Paul Levy 3 , Chris Mutrie 4 , Brad
Wolf 5 , Lawrence Deese 6 , Lynn Wiggins 7 , Vishal Sachdev 8 , Sam Signore 4 ,
Edward Robbins 4
1 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis/TN/
United States of America, 2 Epidemiology and Biostatistics, University of Memphis
School of Public Health, Memphis/TN/United States of America, 3 Cardiothoracic
Surgery, Nea Baptist, Jonesboro/AR/United States of America, 4 Cardiothoracic
Surgery, Baptist Memorial Hospital, Memphis/TN/United States of America,
5 Cardiothoracic Surgery, Baptist Memorial Hospital, Desoto/MS/United States of
America, 6 Cardiothoracic Surgery, Baptist Memorial Hospital, Oxford/MS/United
States of America, 7 Cardiothoracic Surgery, St. Bernard’s Regional Medical Center,
Jonesboro/AR/United States of America, 8 North Mississippi Medical Center, Tupelo/
MS/United States of America
Background: Quality variances in surgical resection and pathology
examination practice translate into survival disparity in patients with early
stage lung cancer after curative-intent resection. We evaluated the survival
patients from two eras in a US regional cohort. Methods: All curative-intent
lung cancer resections in 11 US hospitals in 4 contiguous Dartmouth Hospital
Referral Regions were analyzed for stage-stratified survival before and after
an ongoing regional quality improvement campaign started in 2009. Overall
and stage-stratified survival of patients with surgery in the 2004-2009
(pre-era) v 2010-2015 (post-era) were compared using the log-rank test and Cox
proportional hazards models. Results: Of the total cohort of 3246 patients,
40.6% were in the earlier era, 59.4% in the later era. Demographic
characteristics were similar between cohorts (Table 1). Preoperative PET/CT,
brain MRI scans, bronchoscopy, and adjuvant therapy were more frequently
used in the later era. Patients in the early era had an unadjusted hazard ratio
(HR) of 1.22 (p=0.0006). After controlling for stage, tumor size, neoadjuvant
therapy, comorbidity score, grade, extent of surgery, patients in the pre-era
had a HR of 1.49 (p