European and North American Strategies Differ for Controversial Procedures

Level 1 evidence is often missing in cardiothoracic surgical practice, due to a lack of controlled trials. As a result, standard treatment and management may vary between continents.

ESTS @ STS: Controversial Issues in General Thoracic Surgery

Tuesday, January 30
3:30 p.m. – 5:30 p.m.
Room 316

Those differences will be explored in this afternoon’s collaborative session from STS and the European Society of Thoracic Surgeons (ESTS).

Session moderators Janet P. Edwards, MD, of the University of Calgary in Canada, and ESTS President Kostas Papagiannopoulous, MD, of St. James University Hospital in Leeds, United Kingdom, will lead the comparative discussion on a variety of controversial issues in general thoracic surgery, including the surgical management of lung metastases, multimodal approaches to the treatment of malignant pleural mesothelioma, surgical management of small cell lung cancer, and approaches to treatment of primary chest wall malignancies.

“We selected hot topics that are considered controversial in Europe and North America and chose expert speakers who can give their take on what’s currently happening in each area,” Dr. Edwards said. “Our session will compile the evidence in these domains to help practicing surgeons make the best possible treatment decisions for their patients.”

The speakers will address whether it’s appropriate to operate on lung metastases and whether it actually prolongs survival. Survival after resection of lung metastases likely varies based on many factors, including tumor type. Speakers will provide advice on when metastectomy is advisable, Dr. Edwards said. As for malignant pleural mesothelioma, surgeons will discuss options for multimodal therapy, as well as the availability of clinical trials.

Discussion of limited-stage small cell lung cancer is expected to address which cases should be managed with surgical resection. Finally, surgeons will explore complex reconstruction following a chest wall tumor. Chest wall tumors are relatively uncommon, and some patients may benefit from multimodal therapy.

Considering existing differences in current practice, as well as possible recommendations for change, may convince general thoracic surgeons to rethink treatment in these domains, Dr. Edwards said.