Trends and results of lung cancer surgery in Finland between 2004 and 2014†
Open Access
- 7 January 2018
- journal article
- research article
- Published by Oxford University Press (OUP) in European Journal of Cardio-Thoracic Surgery
- Vol. 54 (1), 127-133
- https://doi.org/10.1093/ejcts/ezx486
Abstract
The aim of this study was to investigate the current trends and results of lung cancer surgery in Finland at the population level. Three compulsory national registries provided the data on surgical treatment of lung cancer during 2004 and 2014. Outcomes of interest were all-cause mortality, population level surgical rates and frequencies of resections. The data were divided into 2 eras to analyse changes in treatment strategies and baseline characteristics: 2004–2009 and 2010–2014. A total of 3621 patients underwent lung resections for cancer during the study period. The mean age of the patients was 65.8 years. During the study period, the patients were older and Charlson comorbidity index score of the patients increased (P < 0.001 for both). Simultaneously, the rate of surgery (from 12.8% to 14.4%, P = 0.001) and the rate of video-assisted thoracoscopic surgery increased (from 7.3% to 31.9%, P < 0.001). The rate of pneumonectomy decreased from 12.7% to 7.5% (P < 0.001). Mortality was 2.3% at 30 days and 4.3% at 90 days without significant differences between eras. Overall survival was 85% at 1 year and 50.2% at 5 years. Long-term survival improved significantly during the study from 53% to 60.1% at 4 years (P < 0.001). This nationwide population-based study demonstrates an improvement in long-term outcome after lung cancer surgery despite an increasing age and comorbidity burden concomitantly with an increasing rate of surgery. This suggests that video-assisted thoracoscopic surgery can be offered to more patients with more comorbidities while still improving lung cancer survival.This publication has 29 references indexed in Scilit:
- Nationwide Quality Improvement in Lung Cancer Care: The Role of the Danish Lung Cancer Group and RegistryJournal of Thoracic Oncology, 2013
- Comparison of 30-day, 90-day and in-hospital postoperative mortality for eight different cancer typesBritish Journal of Surgery, 2012
- National trends in lung cancer surgeryEuropean Journal of Cardio-Thoracic Surgery, 2012
- Variation in surgical resection for lung cancer in relation to survival: Population-based study in England 2004–2006European Journal of Cancer, 2012
- The International Association for the Study of Lung Cancer Staging Project: Prognostic Factors and Pathologic TNM Stage in Surgically Managed Non-small Cell Lung CancerJournal of Thoracic Oncology, 2009
- ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)European Respiratory Journal, 2009
- Regional differences in treatment and outcome in non-small cell lung cancer: A population-based study (Sweden)Lung Cancer, 2009
- Lung Cancer in Elderly Patients: An Analysis of the Surveillance, Epidemiology, and End Results DatabaseJournal of Clinical Oncology, 2007
- Video-Assisted Thoracoscopic Surgery is More Favorable Than Thoracotomy for Resection of Clinical Stage I Non-Small Cell Lung CancerThe Annals of Thoracic Surgery, 2007
- The Finnish Cancer Registry as Follow-Up Source of a Large Trial CohortActa Oncologica, 2002