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. 2020 Sep:137:214-223.
doi: 10.1016/j.ejca.2020.07.008. Epub 2020 Aug 13.

Trends in incidence, diagnosis, treatment and survival of hepatocellular carcinoma in a low-incidence country: Data from the Netherlands in the period 2009-2016

Margot T M Reinders  1 , Suzanne van Meer  2 , Mark C Burgmans  3 , Koert P de Jong  4 , Heinz-Josef Klümpen  5 , Robert A de Man  6 , D Sandjai Ramsoekh  7 , Dave Sprengers  8 , Eric T T L Tjwa  9 , Judith de Vos-Geelen  10 , Karel J van Erpecum  11 , Lydia G M van der Geest  12 ; Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)
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Trends in incidence, diagnosis, treatment and survival of hepatocellular carcinoma in a low-incidence country: Data from the Netherlands in the period 2009-2016

Margot T M Reinders et al. Eur J Cancer. 2020 Sep.

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.

Keywords: Cancer diagnostics; Cancer treatment; Hepatocellular carcinoma; Liver cancer; Survival.

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Conflict of interest statement

Conflict of interest statement M.T.M.R. reports grants from Dutch Cancer Society (KWF Kankerbestrijding); received personal fees from Boston Scientific/BTG, United Kingdom; received other fees from Quirem Medical B.V.; received nonfinancial support from Quirem Medical B.V. and Terumo, outside the submitted work. M.C.B. reports grants from ZonMW Programma Translationeel Onderzoek/Topsector LSH, Maag Lever Darm Stichting; reports receiving nonfinancial support from Quirem Medical for HORA EST HCC study; grants from Covidien for HORA EST HCC study, outside the submitted work. H.J.K. reports receiving personal fees from IPSEN and SIRTEX, outside the submitted work. J.d.V.-G. reports grants and nonfinancial support from Servier, outside the submitted work. K.J.v.E. reports grants from Dutch Cancer Society (KWF Kankerbestrijding), outside the submitted work. All other authors report no conflict of interest.

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