Real-life data on lung cancer (LC) management from Eastern Europe are scarce. We aimed to evaluate LC management data in real-life setting and to identify target areas for development in our center.
A cross-sectional analysis was performed on the data of all patients presented to the Multidisciplinary Tumor Board (MTB) of our institution from 01 June 2019 till 31 May 2020. Age, sex, smoking history, chronic obstructive pulmonary disease (COPD) as comorbidity, pathology results, the prevalence of common driver mutations, expression of programmed death ligand-1 (PD-L1), stage of the disease, performance status (PS) of the patients, applied therapeutic modalities (surgical resection, radiotherapy, systemic oncotherapy) were registered.
Out of 613 patients presented to our MTB, 443 patients had positive cytology/histology for primary LC. 110 patients had no pathological verification, 60 patients were diagnosed with mesothelioma, lymphoma, metastases of other solid tumors or benign diseases. 51% of the LC patients were female; median age was 68 (range 38-91) years. 54% of LC patients were diagnosed with adenocarcinoma (AC), 28% with squamous cell carcinoma (SCC), 14% with small cell lung cancer. 51% of the lung cancer cohort had COPD, with highest prevalence in the SCC subgroup (64%). 40% of the non-small cell lung cancer (NSCLC) patients were in the early stage (IA-IIIA) of the disease at the time of the diagnosis. While 87% of our patients with early-stage AC received radical surgical treatment, only 51% of early-stage SCC patients had a curative resection. Driver mutations were found in advanced and metastatic AC cases with the following prevalences: EGFR 8%, ALK 2%, BRAF 3% (89%, 81%, 56% of cases evaluated, respectively). Immunotherapy was used as first-line treatment in 11%, in second or third line in 43% of NSCLC cases receiving systemic oncotherapy.
There is a high number of patients evaluated for LC but without pathological verification due to low compliance, very severe COPD, or poor PS in a large Eastern European lung cancer center. Early-stage SCC presents a challenge for surgical treatment due to the high prevalence of severe comorbidities. Immunotherapy should gain more ground for locally advanced and metastatic NSCLC.
Clinical trial identification
Legal entity responsible for the study
Department of Pulmonology, Semmelweis University Budapest, Hungary.
Has not received any funding.
All authors have declared no conflicts of interest.