Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide CohortLohman, E. D. S., de Bitter, T., Verhoeven, R., van der Geest, L., Hagendoorn, J., Mohammad, N. H., Daams, F., Klumpen, H-J., van Gulik, T., Erdmann, J., de Boer, M., Hoogwater, F., Koerkamp, B. G., Braat, A., Verheij, J., Nagtegaal, I., van Laarhoven, C., van den Boezem, P., van der Post, R. & de Reuver, P., Apr-2020, In : Cancers. 12, 4, 13 p., 918.
Research output: Contribution to journal › Article › Academic › peer-review
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.
|Number of pages||13|
|Publication status||Published - Apr-2020|
- gallbladder neoplasms, cohort studies, chemotherapy, surgery, epidemiology, SURGICAL-TREATMENT, BILIARY, RESECTION, GEMCITABINE, CHOLECYSTECTOMY, CLASSIFICATION, NEOADJUVANT, CARCINOMAS, STRATEGIES