[Surgical treatment of bronchogenic carcinoma 1970-2001]

Lung cancer (LC) is a permanent medical and social problem. 5709 patients died in the year 2000 of this disease in Czech Republic. Its incidence in men is 100/100,000 and it shows only small trend to decrease. In women the incidence has reached 22/100,000 and is still rising. The ratio males/females in the whole country is 4:1, in pulmonary department of University hospital Motol is close to 2:1. The optimal way of treatment is a surgery.

From the data about diagnostics and operability in Pneumological Clinic of the 1st Medical Faculty of the Charles University (former 2nd Clinic of Tuberculosis and Respiratory Diseases) and from adequate data obtained from the Pulmonary department of University 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 1985-1990 and 1998-2001 we learned the change of the ratio males/females (from 17:1 to 2:1), lower number of 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 clinical when compared to pathological TNM staging was similar in both periods (55% in the period 1985-1990 and 53% in the period 1998-2001). In the article we describe also results of diagnostics, induction and adjuvant treatment and possibilities of the increase of operability of the patients with lung cancer.

The authors think that despite some improvements in several parameters, the 5-year survival of patients with lung cancer is in our country and the whole world still unsatisfactory. We recommend the revision of current attitude to the screening of lung cancer and we recommend joining the running European-American trials of screening of such patients with the help of low-dose spiral CT.