Surgical Treatment of Lung Cancer in Years 1970–2001

Overview

Background.
Lung cancer (LC) is a permanent medical and social problem. 5709 patients diedin the year 2000 of this disease in Czech Republic. Its incidence in men is 100/100 000 and itshows only small trend to decrease. In women the incidence has reached 22/100 000 and is stillrising. The ratio males/females in the whole country is 4:1, in pulmonary department ofUniversity hospital Motol is close to 2:1. The optimal way of treatment is a surgery.Methods and Results. From the data about diagnostics and operability in Pneumological Clinicof the 1st Medical Faculty of the Charles University (former 2nd Clinic of Tuberculosis andRespiratory Diseases) and from adequate data obtained from the Pulmonary department ofUniversity hospital Motol we can see that the number of operated patients increased from 20 %in 1970 to 28 % in 2001. When compared two set of patients operated in the period 1985-1990and 1998-2001 we learned the change of the ratio males/females (from17:1 to 2:1), lower numberof pneumonectomies (from 34%to 31 %), lower number of exploratory thoracotomies (from 13 %to 5 %), decrease of perioperative mortality from 10 % do 2 %. The percentage of correct clinicalwhen compared to pathological TNM staging was similar in both periods (55 % in the period1985–1990 and 53 % in the period 1998–2001). In the article we describe also results ofdiagnostics, induction and adjuvant treatment and possibilities of the increase of operability ofthe patients with lung cancer.Conclusions. The authors think that despite some improvements in several parameters, the5-year survival of patients with lung cancer is in our country and the whole world stillunsatisfactory. We recommend the revision of current attitude to the screening of lung cancerand we recommend joining the running European-American trials of screening of such patientswith the help of low-dose spiral CT.

Key words:
lung cancer, surgical treatment, neoadjuvant and adjuvant treatment.