Margot T M Reinders1, Suzanne van Meer2, Mark C Burgmans3, Koert P de Jong4, Heinz-Josef Klümpen5, Robert A de Man6, D Sandjai Ramsoekh7, Dave Sprengers8, Eric T T L Tjwa9, Judith de Vos-Geelen10, Karel J van Erpecum11, Lydia G M van der Geest12. 1. Department of Radiology & Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands; Department of Gastroenterology & Hepatology, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands. Electronic address: m.t.m.reinders@umcutrecht.nl. 2. Department of Gastroenterology & Hepatology, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands. Electronic address: s.van.meer@antoniusziekenhuis.nl. 3. Department of Radiology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, the Netherlands. Electronic address: m.c.burgmans@lumc.nl. 4. Department of Surgery, University Medical Centre Groningen, P.O. Box 30001, 9700 RB Groningen, the Netherlands. Electronic address: k.p.de.jong@umcg.nl. 5. Department of Medical Oncology, Amsterdam University Medical Centres, P.O. Box 22660, 1100 DD Amsterdam Zuidoost, the Netherlands. Electronic address: h.klumpen@amsterdamumc.nl. 6. Department of Gastroenterology & Hepatology, Erasmus Medisch Centrum Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: r.deman@erasmusmc.nl. 7. Department of Gastroenterology & Hepatology, Amsterdam University Medical Centres, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: d.ramsoekh@amsterdamumc.nl. 8. Department of Gastroenterology & Hepatology, Erasmus Medisch Centrum Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: d.sprengers@erasmusmc.nl. 9. Department of Gastroenterology & Hepatology, Radboud University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. Electronic address: eric.tjwa@radboudumc.nl. 10. Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. Electronic address: judith.de.vos@mumc.nl. 11. Department of Gastroenterology & Hepatology, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands. Electronic address: k.j.vanerpecum@umcutrecht.nl. 12. The Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501 DB Utrecht, the Netherlands. Electronic address: l.vandergeest@iknl.nl.
Abstract
OBJECTIVE: Evaluation of the trends in incidence, diagnostics, treatment and survival of patients with hepatocellular carcinoma (HCC) in the Netherlands. METHOD: Data regarding incidence, diagnostics, primary treatment and survival of patients with HCC in the period 2009-2016 were obtained from the Netherlands Cancer Registry. Trends in incidence, diagnostics, various treatment modalities (except liver transplantation, due to inaccurate data) and regional treatment preferences were analysed. Survival was evaluated using Kaplan-Meier curves and multivariable Cox proportional hazard regression modelling. RESULTS: In the period of 2009-2016, 3838 patients were diagnosed with HCC. A distinct decrease in the percentage of patients who underwent tumour biopsy was observed (from 51% in 2009-2010 to 42% in 2015-2016). Percentage of patients who underwent cancer treatment increased markedly (from 49% in 2009-2010 to 57% in 2015-2016), mainly because of an increasing use of resection and ablation. The number of hospitals where resections were performed or sorafenib treatment prescribed decreased slightly. The number of hospitals sporadically (<1 ablation per year) performing ablations increased. There were significant differences between regions in the application of resection, ablation and transarterial chemoembolisation /radioembolisation (p < 0.05 after 'case mix'-correction). One-, 3- and 5-year survival of patients with HCC significantly improved in the studied period. Receiving cancer treatment was associated with increased survival, whereas increasing age and an advanced tumour stage were both associated with decreased survival. CONCLUSION: From 2009 to 2016, patients with hepatocellular carcinoma more often received cancer treatment and their survival improved. There were significant differences in types of treatment between various regions.
OBJECTIVE: Evaluation of the trends in incidence, diagnostics, treatment and survival of patients with hepatocellular carcinoma (HCC) in the Netherlands. METHOD: Data regarding incidence, diagnostics, primary treatment and survival of patients with HCC in the period 2009-2016 were obtained from the Netherlands Cancer Registry. Trends in incidence, diagnostics, various treatment modalities (except liver transplantation, due to inaccurate data) and regional treatment preferences were analysed. Survival was evaluated using Kaplan-Meier curves and multivariable Cox proportional hazard regression modelling. RESULTS: In the period of 2009-2016, 3838 patients were diagnosed with HCC. A distinct decrease in the percentage of patients who underwent tumour biopsy was observed (from 51% in 2009-2010 to 42% in 2015-2016). Percentage of patients who underwent cancer treatment increased markedly (from 49% in 2009-2010 to 57% in 2015-2016), mainly because of an increasing use of resection and ablation. The number of hospitals where resections were performed or sorafenib treatment prescribed decreased slightly. The number of hospitals sporadically (<1 ablation per year) performing ablations increased. There were significant differences between regions in the application of resection, ablation and transarterial chemoembolisation /radioembolisation (p < 0.05 after 'case mix'-correction). One-, 3- and 5-year survival of patients with HCC significantly improved in the studied period. Receiving cancer treatment was associated with increased survival, whereas increasing age and an advanced tumour stage were both associated with decreased survival. CONCLUSION: From 2009 to 2016, patients with hepatocellular carcinoma more often received cancer treatment and their survival improved. There were significant differences in types of treatment between various regions.