Operability of lung cancer at the Department of Pulmonology, 2nd Faculty of Medicine, Charles University and Motol University Hospital in Prague in 2024 and its development in the Czech Republic in the last 45 years
Authors:
Miloslav Marel 1; Libor Fila 1; Dmitry Rakita 1; Luis Fernando Casas Mendéz 1; Leona Koubková 1; Alžběta Bejčková 1; Zdeňka Chládková 1; Robert Lischke 2; Jan Šimonek 2; Monika Švorcová 2
Authors‘ workplace:
Pneumologická klinika 2. LF UK a FN Motol v Praze
1; 3. chirurgická klinika 1. LF UK a FN Motol v Praze
2
Published in:
Čas. Lék. čes. 2025; 164: 118-124
Category:
Original Article
Overview
In 2024, the multidisciplinary team of the Department of Pulmonology, 2nd Faculty of Medicine, Charles University and Motol University Hospital discussed 454 cases of patients with lung cancer; There were 70 (16%) operated on that year. Patients with adenocarcinoma (52%) in TNM stages I to IIIB prevailed among the operated patients. We administered immunochemotherapy as neoadjuvant treatment to 18 of the operated patients, and 61% of them experienced complete pathological regression. Lobectomies (86%) were significantly more prevalent among surgical procedures, only once the procedure ended with exploratory thoracotomy. We have achieved a 55% agreement between cTNM and pTNM. No one died within 30 days after the operation.
We compared the current results of lung cancer surgery with similar groups of patients from outpatient and clinical departments from the last 45 years. During this time, the number of indications for resection treatment did not increase. The proportion of morphological types of lung carcinoma has changed (increase in adenocarcinomas), procedures performed in patients (lobectomies clearly predominate today) and the number of patients operated on in stages IIIA and IIIB has increased slightly. The agreement between the clinically evaluated extent of the tumor and its actual size determined by the pathologist remains at a very good level, as in the past, and is comparable to the results of the most advanced centers in the world.
The number of indications for resection depends on the timeliness of diagnosis. At present, less than 20% of patients with lung cancer are diagnosed in TNM stages I and II. We see a possible improvement in the increase in the number of participants in lung cancer screening using low-dose CT, which is well organized and available to all interested parties from 2022. The results of this screening known so far confirm a 57% representation of stages I and II of TNM in patients detected in this way.
Keywords:
lung cancer, surgical treatment, screening, adjuvant treatment, neoadjuvant treatment
Sources
- Deboever N, Mitchell KG, Feldman HA et al. Current surgical indications for non-small-cell lung cancer. Cancers 2022; 14: 1263–1278.
- Krejčí D, Mužík J, Šnábl I a kol. Portál epidemiologie novotvarů v České republice. Masarykova univerzita, Brno, 2024. Dostupné na: www.svod.cz
- Marel M, Fila L, Rakita D a kol. Co lze vyčíst z roční statistiky multidisciplinárních týmů (MDT) na fakultním pneumologickém pracovišti? Stud Pneumol Phthiseol 2025 [v tisku].
- Marel M, Kalina P. Problematika bronchogenního karcinomu v činnosti okresního poliklinického zařízení TRN. Stud Pneumol Phthiseol 1986; 46: 598–605.
- Marel M, Melínová L, Šťastný B et al. The result of surgical treatment of non-small cell lung cancer at the Pneumological Clinic in Prague, Czech Republic 1985–1990. Lung Cancer 1994; 11: 293–298.
- Skácel Z. Léčba rakoviny plic na plicním oddělení FN v Praze Motol, 1998–2000. Zdravotnické noviny 2001; 15: 6–8.
- Marel M, Skácel Z, Špásová I a kol. Diagnostika a léčba nemocných s plicním karcinomem na oddělení TRN ve FN Motol v letech 1998–2003. Stud Pneumol Phthiseol 2004; 64: 289–294.
- Marel M, Krejbich F, Stránská P a kol. Analýza anamnestických dat a výsledků vyšetření v souboru 353 nemocných s plicním karcinomem z let 2004–2007. Čas Lék Čes 2009; 148: 416–423.
- Plicková K, Špidlen V, Pešek M, Mukenšnábl P. Analýza přežití pacientů operovaných pro bronchogenní karcinom v letech 1986–1997. Rozhledy v chirurgii 2003; 82: 293–299.
- Skřičková J, Špelda S, Svobodník A et al. A realistic view of the treatment of non-small cell lung cancer. In: Lung Cancer, Current topic. Monduzzi, Bologna, 2001: 167–172
- Yang Y, Liu Z. Neoadjuvant immune checkpoint inhibitor treatment + chemotherapy (vs. chemotherapy alone) for locally advanced non‑small cell lung cancer: a retrospective cohort study. Oncol Lett 2023; 26: 292–299.
- Noy J, Chang A, Chow NP et al. Outcomes of resectable locally advanced non-small cell lung cancer after neoadjuvant chemoimmunotherapy: a single institution experience. J Clin Med 2025; 14: 988–992.
- State of Lung Cancer 2024 Report. American Lung Association. Dostupné na: www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf
- Novotvary 2016. Ústav zdravotnických informací a statistiky ČR. Dostupné na: www.uzis.cz/index.php?pg=record&id=8139
- Van Meerbeeck JP, Franck C. Lung cancer screening in Europe: where are we in 2021? Transl Lung Cancer Res 2021; 10: 2407–2417.
- Drings P, Vogt-Moykopf I. Thorax-tumoren. Springer Verlag, Berlin, Heidelberg, 1991.
- PrevenceProPlice.cz. Průběžné hodnocení a výsledky programu v datech do 30. 9. 2024. Ústav zdravotnických informací a statistiky ČR. Dostupné na: www.prevenceproplice.cz/news-detail/cs/19-prubezne-hodnoceni-a-vysledky-programu-v-datech-do-30-9-2024
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians

Most read in this issue
- Shooting at the Faculty of Arts of Charles University and activation of the trauma plan at the First Surgical Clinic of the General Teaching Hospital
- Clinical obesity – finally a change of paradigm? From BMI to chronic disease
- Amiodarone-induced thyreopaties
- Comparison of performance between artificial intelligence and radiologists in detecting abnormalities on chest X-rays