Outcome of lung cancer surgery and proportion of lung cancer patients eligible for surgery in five Finnish hospitals in 2018, real world study

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.