Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide Cohort
de Savornin Lohman, Elise; de Bitter, Tessa; Verhoeven, Rob; van der Geest, Lydia; Hagendoorn, Jeroen; Mohammad, Nadia Haj; Daams, Freek; Heinz-Josef Klümpen, Klümpen; van Gulik, Thomas; Erdmann, Joris; de Boer, Marieke; Hoogwater, Frederik; Koerkamp, Bas Groot; Braat, Andries; Verheij, Joanne; Nagtegaal, Iris; van Laarhoven, Cornelis; van den Boezem, Peter; van der Post, Rachel; de Reuver, Philip
(2020) Cancers, volume 12, issue 4
(Article)
Abstract
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.
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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.
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Keywords: Chemotherapy, Cohort studies, Epidemiology, Gallbladder neoplasms, Surgery, epidemiology, cohort studies, gallbladder neoplasms, chemotherapy, surgery, Oncology, Cancer Research, Journal Article
ISSN: 2072-6694
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
Note: Funding Information: 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. 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.
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