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. 2020 Apr 9;12(4):918.
doi: 10.3390/cancers12040918.

Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide Cohort

Elise de Savornin Lohman  1 , Tessa de Bitter  2 , Rob Verhoeven  1   3 , Lydia van der Geest  3 , Jeroen Hagendoorn  4 , Nadia Haj Mohammad  5 , Freek Daams  6 , Heinz-Josef Klümpen  7 , Thomas van Gulik  8 , Joris Erdmann  8 , Marieke de Boer  9 , Frederik Hoogwater  9 , Bas Groot Koerkamp  10 , Andries Braat  11 , Joanne Verheij  12 , Iris Nagtegaal  2 , Cornelis van Laarhoven  1 , Peter van den Boezem  1 , Rachel van der Post  2 , Philip de Reuver  1
Affiliations

Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide Cohort

Elise de Savornin Lohman et al. Cancers (Basel). .

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. 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.

Keywords: chemotherapy; cohort studies; epidemiology; gallbladder neoplasms; surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient flow.
Figure 2
Figure 2
Trends in treatment in resected, non-resected non-metastatic, and metastatic gallbladder cancer (GBC). The grey area represents a subgroup analysis of resected patients with early (T1b/T2) gallbladder cancer. Percentages are only displayed when significant differences (p < 0.05) between periods were found. Supportive treatment includes endoscopic procedures, biliary drainage and metastasectomy.
Figure 3
Figure 3
(A): Survival according to time period. (B): Survival according to disease stage.
None
None
See this image and copyright information in PMC

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