TY - JOUR
T1 - Trends in treatment and survival of gallbladder cancer in the Netherlands; Identifying gaps and opportunities from a nation-wide cohort
AU - de Savornin Lohman, Elise
AU - de Bitter, Tessa
AU - Verhoeven, Rob
AU - van der Geest, Lydia
AU - Hagendoorn, Jeroen
AU - Mohammad, Nadia Haj
AU - Daams, Freek
AU - Heinz-Josef Klümpen, Klümpen
AU - van Gulik, Thomas
AU - Erdmann, Joris
AU - de Boer, Marieke
AU - Hoogwater, Frederik
AU - Koerkamp, Bas Groot
AU - Braat, Andries
AU - Verheij, Joanne
AU - Nagtegaal, Iris
AU - van Laarhoven, Cornelis
AU - van den Boezem, Peter
AU - van der Post, Rachel
AU - de Reuver, Philip
N1 - Funding Information: Funding: This study was supported by a grant from the ADP foundation (Chamber of Commerce number 55695817). The funding source did not play a role in study design, data collection, data interpretation, data analysis, the writing of the manuscript or the decision to submit the article for publication. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/4
Y1 - 2020/4
N2 - Gallbladder cancer (GBC) is rare in Western populations and data about treatment and outcomes are scarce. This study aims to analyze survival and identify opportunities for improvement using population-based data from a low-incidence country. GBC patients diagnosed between 2005 and 2016 with GBC were identified from the Netherlands Cancer Registry. Patients were grouped according to time period (2005-2009/2010-2016) and disease stage. Trends in treatment and overall survival (OS) were analyzed. In total 1834 patients were included: 661 (36%) patients with resected, 278 (15%) with non-resected non-metastatic, and 895 (49%) with metastatic GBC. Use of radical versus simple cholecystectomy (12% vs. 26%, p < 0.001) in early (pT1b/T2) GBC increased. More patients with metastatic GBC received chemotherapy (11% vs. 29%, p < 0.001). OS improved from 4.8 months (2005-2009) to 6.1 months (2010-2016) (p = 0.012). Median OS increased over time (2005-2009 vs. 2010-2016) in resected (19.4 to 26.8 months, p = 0.038) and metastatic (2.3 vs. 3.4 months, p = 0.001) GBC but not in unresected, non-metastatic GBC. In early GBC, patients with radical cholecystectomy had a median OS of 76.7 compared to 18.4 months for simple cholecystectomy (p < 0.001). Palliative chemotherapy showed superior (p < 0.001) survival in metastatic (7.3 versus 2.1 months) and non-resected non-metastatic (7.7 versus 3.5 months) GBC. In conclusion, survival of GBC remains poor. Radical surgery and palliative chemotherapy appear to improve prognosis but remain under-utilized.
AB - Gallbladder cancer (GBC) is rare in Western populations and data about treatment and outcomes are scarce. This study aims to analyze survival and identify opportunities for improvement using population-based data from a low-incidence country. GBC patients diagnosed between 2005 and 2016 with GBC were identified from the Netherlands Cancer Registry. Patients were grouped according to time period (2005-2009/2010-2016) and disease stage. Trends in treatment and overall survival (OS) were analyzed. In total 1834 patients were included: 661 (36%) patients with resected, 278 (15%) with non-resected non-metastatic, and 895 (49%) with metastatic GBC. Use of radical versus simple cholecystectomy (12% vs. 26%, p < 0.001) in early (pT1b/T2) GBC increased. More patients with metastatic GBC received chemotherapy (11% vs. 29%, p < 0.001). OS improved from 4.8 months (2005-2009) to 6.1 months (2010-2016) (p = 0.012). Median OS increased over time (2005-2009 vs. 2010-2016) in resected (19.4 to 26.8 months, p = 0.038) and metastatic (2.3 vs. 3.4 months, p = 0.001) GBC but not in unresected, non-metastatic GBC. In early GBC, patients with radical cholecystectomy had a median OS of 76.7 compared to 18.4 months for simple cholecystectomy (p < 0.001). Palliative chemotherapy showed superior (p < 0.001) survival in metastatic (7.3 versus 2.1 months) and non-resected non-metastatic (7.7 versus 3.5 months) GBC. In conclusion, survival of GBC remains poor. Radical surgery and palliative chemotherapy appear to improve prognosis but remain under-utilized.
KW - Chemotherapy
KW - Cohort studies
KW - Epidemiology
KW - Gallbladder neoplasms
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85083803473&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers12040918
DO - https://doi.org/10.3390/cancers12040918
M3 - Article
C2 - 32283627
SN - 2072-6694
VL - 12
JO - Cancers
JF - Cancers
IS - 4
M1 - 918
ER -