Treatment of Lung Carcinoma Patients at the First Department of Tuberculosis and Respiratory Diseases

Overview

Lung carcinoma (BCA) represents the most frequent malignancy in men and the fourth most frequent one in women. In 2004, 5568 persons died from that disease. Study of the lung carcinoma has been the main research program of the First Department of Tuberculosis and Respiratory Diseases of the First Faculty of Medicine, Charles University and General Teaching Hospital since 1960. The presented article summarises results from present and older studies which can show that numbers of diagnosed BCA patients increased since 1960 till 1977, when they reached 96 cases. Since that time the situation has been stabile and the present number of newly diagnosed cases is about 90 cases. Ratio of men and women has changed – since the cohort in 1960 to1961 with ratio 8:1, to the present ratio 2:1. Number of cases diagnosed at the first and second stadium decreased from 56% at the beginning of our study in 1960 to1961 to 19.9% in the cohort from 2004 to 2006. Occurrence of individual structural types of carcinomas has also changed; the second position after the epidermoid types has now adenocarcinoma. Number of microscopically verified BCA cases increased from 32% at the beginning to 79% at present. Proportion of treatment methods has also changed. Surgical treatment increased from 10.1% in 1960–1961 to 16.7% in 1985–1987 and remained stabile since that. Radiotherapy was used in 10% of cases in 1960 to 1961 and in 39.5% in 2004 to 2006. Number of patients with chemotherapy increased from 41% to 58% during the same period. In 2004 to 2006 bronchoscopy verified 95% of cases with direct tumor changes, 54% of indirect changes and in 20% bronchoscopy revealed normal picture. Our results show that the treatment approaches for patients with BCA has developed with the constant necessity to improve the assessment, diagnostics and therapy of new cases. 

Key words:
lung carcinoma, adenocarcinoma, pulmonary surgery.