Onkológia 4/2023

Do we know the number of lung cancer patients in Slovakia?

Objective: Analysis of the morphological, immunohistochemical, and genetic attributes of primary lung cancer patients in Slovak Republic (SR) based on nationwide epidemiological study. Patients and Methods: A descriptive retrospective study on a representative sample (37.5% of all malignant lung tumors in SR) analyzes all histological subtypes, results of selected immunohistochemical tests (PD-L1 expression), and all genetic tests. In the period from 2018-2022, the study included n=5,781 cases of primary malignant lung tumors in the SR. However, due to the situation during the Covid-19 pandemic, only the results from the full years 2021 and 2022 were summarized into the presented analysis (n=2,404 collected cases). Results: Of the adult patients in 2021-2022 in SR, 76.32% had NSCLC and the remaining 23.68% had another morphological type of malignant lung tumor. Of the NSCLC patients, 37.68% had the squamous cell type and 62.32% of patients had other subtypes. Among NSCLC patients, 23.38% had a PD-L1 expression at the level of ≥50 %, 75.12% had expression levels < 50%, and 1.50% had an unknown/ unrepresentative PD-L1 result. Among non-squamous NSCLC patients, 26.60% had PD-L1 expression levels of ≥ 50%, 71.61% had < 50%, and 1.79% had an unknown/unrepresentative result. EGFR and/or ALK were examined in 70.23% of NSCLC patients. Of the patients with non-squamous NSCLC, 89.76% were tested for EGFR and/or ALK, with 85.30% specifically tested for EGFR and 77.17% for ALK. Conclusion: The publication presents selected results of the nationwide epidemiological study of malignant lung tumors in the SR. Using the EpiView® online application, it’s possible to quantify selected group of patients based on the representation of individual morphological types of malignant lung tumors, clinical stages of the disease, immunohistochemical determination of PD-L1 expression, and comprehensive genetic testing (including EGFR, ALK, ROS, and others).

Keywords: lung cancer, epidemiology, histology, PD-L1, EGFR, ALK