Multicenter study of diagnostic procedures, genetic aberration analysis, and first-line treatment of lung cancer in Jiangsu Province, China: Status quo of lung cancer in China

BACKGROUND: Jiangsu Province, China, is highly developed economically and culturally, and has a high prevalence of lung cancer. We aimed to evaluate the diagnostic procedures, genetic aberration analysis status, and first-line treatment models of lung cancer in Jiangsu Province. METHODS: Lung cancer patients diagnosed in 2016 at 22 tertiary care hospitals were evaluated. Demographic characteristics, tumor histology, staging, family history of lung cancer, auxiliary examinations, genetic testing, and first-line treatment were collected on discharge. Diagnostic and treatment data were analyzed by descriptive statistics. RESULTS: A total of 928 patients were enrolled. Chest computed tomography was the most frequently used diagnostic method; pathology diagnosis was carried out by transbronchial lung biopsy and transthoracic needle aspiration. Stage T1-2N0M0 small-cell lung cancer patients experienced surgical resection, and others received cisplatin and etoposide chemotherapy. Stage I and stage II non-small cell lung cancer patients experienced surgical resection; stage III and stage IV patients received cisplatin and pemetrexed chemotherapy as first-line treatment. Detection of epidermal growth factor receptor (EGFR) mutations occurred in 29.9% of non-selective, 36.5% of locally advanced or metastatic, and 42.1% of advanced non-squamous non-small cell lung cancer. The overall EGFR-positive rates were 49.0%, 52.5%, and 53.9%. A total 72.0% of patients with EGFR mutations were treated with tyrosine kinase inhibitors. CONCLUSION: Chest computed tomography was the most commonly performed diagnostic method for lung cancer. First-line treatment was primarily determined by disease stages and EGFR mutation status, with few expectations.