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Gender Differences Shown in Surgery for Lung Cancer: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 7, 2010 -- Women with lung cancer undergo significantly fewer video-assisted thoracic surgery (VATS) procedures than male lung cancer patients. They also have higher in-hospital mortality rates, investigators announced here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). Haisar Dao, MD, St. Elizabeth’s Medical Center, Boston, Massachusetts, and colleagues conducted a study to determine the presence of gender disparities and outcomes in the surgical management of lung cancer. Thoracoscopy has evolved with the introduction of video technology and endoscopic instruments, Dr. Dao noted. With improvement in optical technology and lighting systems, VATS has become an acceptable alternative to traditional open procedures. However, a “major force” behind VATS procedures has been patient demand for cosmesis and postoperative pain in the short term, he added. What’s more, long-term results and benefits have not been clearly demonstrated, and more importantly, the oncologic validity of VATS procedures has not been rigourously assessed. In addition, patient selection has not been determined. For their study, the investigators reviewed a large healthcare database known as the Nationwide Inpatient Sample from Healthcare Cost and Utilization Project for the years 2005 to 2007. The database included approximately 25 million patients, and a total of 23,025 surgical interventions for lung cancer. Of these, 18,832, or 82%, were open procedures and 4,893, or 18%, were VATS. The primary outcomes were the identification of likelihood of procedure utilisation depending on gender and in-hospital mortality. The mean age of the study group was 67 +- 10 years. The investigators found no differences in the rate of utilisation of open procedures versus VATS in white patients and non-whites (odds ratio [OR] = 1.010; P = .8799). Male patients were more likely to undergo VATS than females (23.24% vs 19.25% for the 2 groups, respectively (OR = 1.173; P < .0001). The overall in-hospital mortality rate was higher for females (3.11%) than males (1.95%; OR = 1.753; P < .0001). The in-hospital mortality rate was not statistically significantly different among white and non-white patients (OR = 7.802; P = .137). “Our study is the first to suggest gender disparities in utilisation and in-hospital mortality of VATS versus open procedures,” Dr. Dao said. Further research, he added, is needed to explain the observed gender differences, he added. [Presentation title: Gender Disparities and Outcomes in the Surgical Management of Lung Cancer. Analysis of the NIS: 2005-2007. Abstract P310] E-mail this page to a friend or colleague! To print, use this version