Non-Small Cell Lung Cancer in Countries of Central and Southeastern Europe: Diagnostic Procedures and Treatment Reimbursement Surveyed by the Central European Cooperative Oncology Group.

This article analyzes the availability of different diagnostic procedures of non-small cell lung cancer (NSCLC) and the reimbursement landscape of drugs for NSCLC in countries of central and southeastern Europe (CEE). A survey was conducted by the Central European Cooperative Oncology Group. Results of the survey show that both availability and reimbursement of diagnoses of molecular alterations in NSCLC, the detection of which is essential for therapeutic decisions, varies widely between countries of CEE. Not only is "reflex" testing often substituted by analyses performed only "on demand," but reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. It was concluded that a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. IMPLICATIONS FOR PRACTICE: This article provides an overview of the limitations in lung cancer treatment in countries of central and southeastern Europe, as well as the reimbursement status of various lung cancer treatment regimens in these countries, which directly impacts treatment options.

Influence of narrow band imaging (NBI) videobronchoscopy on the assessment of central lung cancer extension and therapeutic decision.

OBJECTIVES: Determination of specificity and sensitivity of narrow band imaging (NBI) in the assessment of tumor extension in centrally located lung cancer, when compared to white light bronchoscopy (WLB) alone, and evaluation of possible influence of NBI on therapeutic decision in patients with lung cancer. PATIENTS AND METHODS: We evaluated 36 patients with suspected lung cancer. All patients underwent WLB followed by NBI bronchoscopy. We were using videobronchoscope BF-1T180 and EVIS LUCERA SPECTRUM processor unit. RESULTS: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for NBI in the assessment of tumor extension were 97.8, 85, 93.7, and 94.4%, respectively; and for WLB 92.3, 60, 69.6, and 88.9%, respectively. In 14 patients, NBI revealed more extensive tumor than WLB (p =.0057). In eight patients, NBI showed significant influence on therapeutic decision (p =.001). CONCLUSION: NBI videobronchoscopy had better specificity and sensitivity in the assessment of tumor extension in centrally located lung cancer, and it might play a significant role in the therapeutic decision.