Outcome of lung cancer surgery and proportion of lung cancer patients eligible for surgery in five Finnish hospitals in 2018, real world study
DOI:
https://doi.org/10.2340/1651-226X.2025.43398Keywords:
lung cancer, surgery, operability, survival, limited stageAbstract
Background and purpose: Lung cancer is one of the most common malignancies worldwide and is associated with high mortality. In Finland, overall lung cancer survival is lower than in other Nordic countries. A recent Finnish Cancer Registry publication reported that only 11.8% of patients underwent surgery. We aimed to assess whether operability and surgical outcomes contribute to Finland’s inferior lung cancer survival rates.
Material and methods: This retrospective study analysed patient data of five Finnish hospital databases. We focused on potentially operable patients, specifically those with non-small cell lung cancer in stage I–IIIA according to computer tomography. A total of 156 patients met the staging criteria, of whom 77 underwent surgery. Among potentially operable patients, 50.6% were deemed ineligible for surgery due to various factors, including poor pulmonary or cardiac function, comorbidities, or localised tumour spread.
Results: In our material 156 out of 545 were potentially operable and 77 were operated. 2-year overall survival for operated patients was 79%.
Interpretation: We found that patients with lung cancer in Finland present with poorer overall health, a slightly more advanced stage distribution among potentially operable cases, and a lower overall rate of surgical treatment compared to other Nordic countries. Additionally, patients in Finland tend to undergo surgery at more advanced stages. These factors likely contribute to Finland’s lower lung cancer survival rates. This study underscores that delayed diagnosis and a lower proportion of patients undergoing surgery may be key contributors to Finland’s poorer treatment outcomes.
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References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
https://doi.org/10.3322/caac.21660 DOI: https://doi.org/10.3322/caac.21660
Zhang Y, Vaccarella S, Morgan E, Li M, Etxeberria J, Chokunonga E, et al. Global variations in lung cancer incidence by histological subtype in 2020: a population-based study. Lancet Oncol. 2023;24(11):1206–18.
https://doi.org/10.1016/S1470-2045(23)00444-8 DOI: https://doi.org/10.1016/S1470-2045(23)00444-8
Ahvonen J, Luukkaala T, Laitinen T, Jukkola A. Survival with lung cancer in Finland has not improved during 2007–2019 – a single center retrospective population-based real-world study. Acta Oncol. 2023;62(6):571–8.
https://doi.org/10.1080/0284186X.2023.2213444 DOI: https://doi.org/10.1080/0284186X.2023.2213444
Nordcan 2.0 [Internet]. [cited 2025 Mar 12]. Available from: https://nordcan.iarc.fr/en/dataviz/survival?cancers=160&set_scale=0&years_available=1943_2021&sexes=1
Lundberg FE, Ekman S, Johansson ALV, Engholm G, Birgisson H, Ólafsdóttir EJ, et al. Trends in lung cancer survival in the Nordic countries 1990–2016: the NORDCAN survival studies. Lung Cancer. 2024;192:107826.
https://doi.org/10.1016/j.lungcan.2024.107826 DOI: https://doi.org/10.1016/j.lungcan.2024.107826
Näin keuhkosyöpäpotilaiden hoitopolut eroavat toisistaan Suomessa – FICAN [Internet]. Finnish [cited 2024 Dec 5]. Available from: https://fican.fi/nain-keuhkosyopapotilaiden-hoitopolut-eroavat-toisistaan-suomessa/
ECOG-ACRIN Cancer Research Group. ECOG performance status scale [Internet]. [cited 2024 Dec 12]. Available from: https://ecog-acrin.org/resources/ecog-performance-status/
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.
https://doi.org/10.1016/0021-9681(87)90171-8 DOI: https://doi.org/10.1016/0021-9681(87)90171-8
Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–51.
https://doi.org/10.1016/0895-4356(94)90129-5 DOI: https://doi.org/10.1016/0895-4356(94)90129-5
Årsrapport for lungekreft [Internet]. Norwegian [cited 2024 Apr 14]. Available from: https://www.kreftregisteret.no/Generelt/Rapporter/Arsrapport-fra-kvalitetsregistrene/Arsrapport-for-lungekreft/
Lungnakrabbamein [Internet]. Icelandic. 2023 [cited 2024 Jul 3].
Available from: https://www.krabb.is/krabbamein/tegundir-krabbameina/lungnakrabbamein
Oskarsdottir GN, Lampa E, Berglund A, Rosengren L, Ulvestad M, Boros M, et al. Real-world treatment patterns and survival outcomes for patients with non-metastatic non-small-cell lung cancer in Sweden: a nationwide registry analysis from the I-O optimise initiative. Cancers (Basel). 2024;16(9):1655.
https://doi.org/10.3390/cancers16091655 DOI: https://doi.org/10.3390/cancers16091655
Ehrenstein V, Eriksen K, Taylor A, Servidio L, Jakobsen E. Characteristics and overall survival of patients with early-stage non-small cell lung cancer: a cohort study in Denmark. Cancer Med. 2023;12(1):30–7.
https://doi.org/10.1002/cam4.4946 DOI: https://doi.org/10.1002/cam4.4946
ESMO Clinical Practice Guideline: Early Stage and Locally Advanced Non-Small Cell Lung Cancer. Available from https://www.esmo.org/guidelines/esmo-clinical-practice-guideline-early-stage-and-locally-advanced-non-small-cell-lung-cancer
Syöpärekisteri [Internet]. Keuhkosyöpä Suomessa. [cited 2025 Mar 18]. Available from: https://syoparekisteri.fi/assets/files/2024/12/Keuhkosyopa_Suomessa.pdf
Tsai LL, Chu NQ, Blessing WA, Moonsamy P, Colson YL. Lung cancer in women. Ann Thorac Surg. 2022;114(5):1965–73.
https://doi.org/10.1016/j.athoracsur.2021.09.060 DOI: https://doi.org/10.1016/j.athoracsur.2021.09.060
Syöpärekisteri [Internet]. Syöpätilastosovellus. Finnish. [cited 2024 Dec 12]. Available from: https://syoparekisteri.fi/tilastot/tautitilastot/
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Copyright (c) 2025 Ville Paappanen, Jenny Tikka, Arja Jukkola, Tuula Klaavuniemi, Liisa Sailas, Maria Tengström, Hanne Kuitunen, Teemu Riekkinen, Satu Tiainen, Outi Kuittinen
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