title: Palliative interventional pulmonology procedures in the incarcerated population with cancer: a case series.
abstract: BACKGROUND
  Cancer is the second most common cause of death in incarcerated population and lung cancer is the most common cause of cancer death in this group. Inmates are excluded from most published surveys and research,thus the effectiveness of lung cancer palliation in this population is not known.
  
  
  OBJECTIVE
  To report the feasibility and safety of palliative interventional pulmonary procedures in inmates with cancer.
  
  
  METHODS
  Retrospective review of registry data from a single center.
  
  
  METHODS
  Inmate data on prospectively enrolled data registry (2009–2012) from the interventional pulmonology procedural registry at Virginia Commonwealth University was extracted and analyzed for safety and efficacy. Inmates with lung cancer and advanced malignancies with pleural or airway metastasis requiring airway debulking (mechanical/thermal), airway stenting, and tunneled pleural catheter (TPC) placement were included in the analysis.
  
  
  RESULTS
  A total of 16 procedures were performed in 12 incarcerated patients. These included six TPC placements in six patients. Ten procedures were performed in seven patients with airway obstruction. These procedures included rigid and flexible bronchoscopy with mechanical (rigid and balloon dilation) and thermal (laser, argon plasma coagulation, and cautery) tumor debulking and dilation,airway stenting, and tracheostomy in one case. All six TPCpatients had immediate symptomatic relief and improved lung aeration on chest radiograph. Three of six patients had successful auto-pleurodesis. In the seven patients with airway obstruction, three patients reported symptomatic relief and one had resolution of post-obstructive pneumonia. No immediate- or long-term procedure-related complications were reported.
  
  
  CONCLUSIONS
  Incarcerated patients with advanced malignancy may benefit from interventional pulmonology procedures with low complications. Palliative interventional pulmonology procedures in inmates should not be withheld solely on their incarceration status.
authors.forename: Samira
authors.initials: S
authors.lastname: Shojaee
authors.forename: S
authors.initials: S
authors.lastname: Shojaee
authors.forename: Janet
authors.initials: J
authors.lastname: Dawson
authors.forename: J
authors.initials: J
authors.lastname: Dawson
authors.forename: Ray W
authors.initials: RW
authors.lastname: Shepherd
authors.forename: R W
authors.initials: RW
authors.lastname: Shepherd
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Lee
authors.forename: H J
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000379:methods; D017115:Catheter Ablation / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000401:mortality; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011329:Prisoners / Q000706:statistics & numerical data*; D011379:Prognosis; D015272:Pulmonary Medicine / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D019452:Terminally Ill; D014057:Tomography, X-Ray Computed / Q000379:methods; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome; D014768:Virginia