PURPOSE: To describe the recent situation in diagnosis of lung cancer. To look for reasons of low operability of lung cancer patients (pts) by detailed study of case history.
METHODS: A retrospective study on 209 consecutive lung cancer pts. A special attention was paid to the relation between smoking status and the onset of lung cancer and to the coincidence with COPD.
RESULTS: 140 men and 69 women (ratio 2:1) were studied. There were 63 % of recent smokers, 25 % of ex-smokers and 12 % of never smokers. Lung cancer was diagnosed in significantly earlier age in smokers (median age men 66, women 61 years) than in non- and ex-smokers (median age men 69, women 74 years). Significantly earlier stages of lung cancer were diagnosed in COPD pts. Histological type of lung cancer was assessed in 171 pts. Squamous cell and adenocarcinoma were the most frequent types, both in 28 %. Adenocarcinoma was the most frequent type in nonsmoking women (37 %). 74 pts (35 %) were diagnosed in potentially resectable stages I –IIIA, however only 35 pts of them underwent surgery. The reasons for inoperability in 40 potentially resectable pts were as follows: COPD stage III-IV in 9, age over 80 years with polymorbidity in 8, bad general status in 7, congestive heart failure in 5 and refusing of surgery in 4 pts. The tumor was rated as inoperable during the surgery in 4 of 35 resected pts.
CONCLUSION: The diagnosis of lung cancer was late in 65 % of studied pts. Lung cancer was diagnosed in significantly lower age in current smokers and in significantly earlier stages in COPD pts. The most frequent reasons for inoperability in potentially operable pts were severe COPD and high age with polymorbidity.
CLINICAL IMPLICATIONS: New information about the lower age of onset of lung cancer in current smokers and about coincidence of earlier stages of lung cancer with COPD may help to physicians to diagnose lung cancer in earlier stages.
DISCLOSURE: Miloslav Marel, None.