M van Putten1, J de Vos-Geelen2, G A P Nieuwenhuijzen3, P D Siersema4, V E P P Lemmens5, C Rosman6, M J C van der Sangen7, R H A Verhoeven8. 1. Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), The Netherlands. Electronic address: m.vanputten@iknl.nl. 2. Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, The Netherlands. 3. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. 4. Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands. 5. Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), The Netherlands; Department of Public Health, Erasmus Medical Centre Rotterdam, The Netherlands. 6. Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. 7. Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands. 8. Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), The Netherlands.
Abstract
BACKGROUND: Treatment for oesophageal cancer has evolved due to developments including the centralisation of surgery and introduction of neoadjuvant treatment. Therefore, this study evaluated trends in stage distribution, treatment and survival of oesophageal cancer patients in the last 26 years in the Netherlands. PATIENTS AND METHODS: Patients with oesophageal cancer diagnosed in the period 1989-2014 were selected from the Netherlands Cancer Registry. Patients were divided into two groups: non-metastatic (M0) and metastatic (M1). Trends in stage distribution, treatment and relative survival rates were evaluated according to histology. RESULTS: Among all 35,760 patients, the percentage of an unknown tumour stage decreased from 34% to 10% during the study period, whereas the percentage of patients with metastatic disease increased from 21% to 34%. Among surgically treated patients 32% underwent a resection in a high-volume hospital in 2005 which increased to 92% in 2014. Use of neoadjuvant chemoradiotherapy increased in non-metastatic oesophageal adenocarcinoma (OAC) and squamous cell carcinoma (OSCC) patients from respectively 4% and 2% in 2000-2004 to 43% and 26% in 2010-2014. Five-year relative survival increased from 8% to 22% for all patients; from 12% to 36% for non-metastatic OAC and from 9% to 27% for non-metastatic OSCC over 26 years. Median overall survival of metastatic patients improved from 18 to 22 weeks. CONCLUSION: In the Netherlands, survival for oesophageal cancer patients improved significantly, especially in the period 2005-2014 which might be the result of better treatment related to the centralisation of surgery and introduction of neoadjuvant chemoradiotherapy.
BACKGROUND: Treatment for oesophageal cancer has evolved due to developments including the centralisation of surgery and introduction of neoadjuvant treatment. Therefore, this study evaluated trends in stage distribution, treatment and survival of oesophageal cancerpatients in the last 26 years in the Netherlands. PATIENTS AND METHODS: Patients with oesophageal cancer diagnosed in the period 1989-2014 were selected from the Netherlands Cancer Registry. Patients were divided into two groups: non-metastatic (M0) and metastatic (M1). Trends in stage distribution, treatment and relative survival rates were evaluated according to histology. RESULTS: Among all 35,760 patients, the percentage of an unknown tumour stage decreased from 34% to 10% during the study period, whereas the percentage of patients with metastatic disease increased from 21% to 34%. Among surgically treated patients 32% underwent a resection in a high-volume hospital in 2005 which increased to 92% in 2014. Use of neoadjuvant chemoradiotherapy increased in non-metastatic oesophageal adenocarcinoma (OAC) and squamous cell carcinoma (OSCC) patients from respectively 4% and 2% in 2000-2004 to 43% and 26% in 2010-2014. Five-year relative survival increased from 8% to 22% for all patients; from 12% to 36% for non-metastatic OAC and from 9% to 27% for non-metastatic OSCC over 26 years. Median overall survival of metastatic patients improved from 18 to 22 weeks. CONCLUSION: In the Netherlands, survival for oesophageal cancerpatients improved significantly, especially in the period 2005-2014 which might be the result of better treatment related to the centralisation of surgery and introduction of neoadjuvant chemoradiotherapy.
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Authors: Judith de Vos-Geelen; Sandra Me Geurts; Margreet van Putten; Liselot Bj Valkenburg-van Iersel; Heike I Grabsch; Nadia Haj Mohammad; Frank Jp Hoebers; Chantal V Hoge; Paul M Jeene; Evelien Jm de Jong; Hanneke Wm van Laarhoven; Tom Rozema; Marije Slingerland; Vivianne Cg Tjan-Heijnen; Grard Ap Nieuwenhuijzen; Valery Epp Lemmens Journal: World J Gastroenterol Date: 2019-12-21 Impact factor: 5.742