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Perioperative treatment and radical cystectomy for bladder cancer – a population based trend analysis of 10,338 patients in the Netherlands
Abstract Background In Europe, population-based data concerning perioperative treatment (PT) and radical cystectomy (RC) are lacking. We assessed temporal trends in PT (neoadjuvant chemotherapy [NAC], neoadjuvant radiotherapy [NAR], adjuvant chemotherapy [AC], adjuvant radiotherapy [AR]) and RC in t...
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| Published in: | European journal of cancer (1990) 2016-02, Vol.54, p.18-26 |
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| container_title | European journal of cancer (1990) |
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| creator | Hermans, Tom J.N Fransen van de Putte, Elisabeth E Horenblas, Simon Lemmens, Valery Aben, Katja van der Heijden, Michiel S Beerepoot, Laurens V Verhoeven, Rob H van Rhijn, Bas W.G |
| description | Abstract Background In Europe, population-based data concerning perioperative treatment (PT) and radical cystectomy (RC) are lacking. We assessed temporal trends in PT (neoadjuvant chemotherapy [NAC], neoadjuvant radiotherapy [NAR], adjuvant chemotherapy [AC], adjuvant radiotherapy [AR]) and RC in the Netherlands and identified patients' and hospital characteristics associated with PT. Methods This nationwide, retrospective, population-based study included cTa/is, T1-4, N0-3, M0-1 bladder cancer patients from the Netherlands Cancer Registry who underwent RC with curative intent between 1995 and 2013. PT-administration over time was compared with chi-square tests. Multivariable logistic regression analyses were performed to identify characteristics associated with PT usage. The sub-groups cT2-4N0M0 and cT2-4, N0 or NX, M0 or MX were separately analysed. Results In total, 10,338 patients met inclusion criteria. Eighty-six percent did not receive PT, 7.0% received NAC (or induction chemotherapy [IC]), 3.2% NAR, 1.8% AC, and 2.1% AR. NAC usage increased from 0.6% in 1995 to 21% in 2013 (p |
| doi_str_mv | 10.1016/j.ejca.2015.11.006 |
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We assessed temporal trends in PT (neoadjuvant chemotherapy [NAC], neoadjuvant radiotherapy [NAR], adjuvant chemotherapy [AC], adjuvant radiotherapy [AR]) and RC in the Netherlands and identified patients' and hospital characteristics associated with PT. Methods This nationwide, retrospective, population-based study included cTa/is, T1-4, N0-3, M0-1 bladder cancer patients from the Netherlands Cancer Registry who underwent RC with curative intent between 1995 and 2013. PT-administration over time was compared with chi-square tests. Multivariable logistic regression analyses were performed to identify characteristics associated with PT usage. The sub-groups cT2-4N0M0 and cT2-4, N0 or NX, M0 or MX were separately analysed. Results In total, 10,338 patients met inclusion criteria. Eighty-six percent did not receive PT, 7.0% received NAC (or induction chemotherapy [IC]), 3.2% NAR, 1.8% AC, and 2.1% AR. NAC usage increased from 0.6% in 1995 to 21% in 2013 (p < 0.001), application of NAR decreased from 15% to 0.4% (p < 0.001). Usage of AC and AR in 2013 was <1.5%. Comparable temporal trends were found in 6032 patients staged cT2-4N0M0. Multivariable logistic regression analysis revealed that younger age, ≥cT3, ≥cN1 and treatment in academic/teaching hospitals were associated with NAC or IC (all p < 0.05). Conclusions The increase in NAC administration in the Netherlands reflects a slow but steady adoption of evidence-based guidelines over the last two decades. Considerable variability in patients' and hospital characteristics in the likelihood of receiving NAC exists. Conversely, NAR, AR and AC are hardly administered anymore.</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2015.11.006</identifier><identifier>PMID: 26707593</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adjuvant ; Adolescent ; Adult ; Age Factors ; Aged ; Bladder ; Cancer ; Chemotherapy ; Chemotherapy, Adjuvant ; Child ; Child, Preschool ; Cystectomy ; Cystectomy - trends ; Female ; Hematology, Oncology and Palliative Medicine ; Hospitals, Teaching ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Neoadjuvant ; Neoadjuvant Therapy - trends ; Neoplasm Grading ; Neoplasm Staging ; Netherlands - epidemiology ; Practice Patterns, Physicians' - trends ; Radiotherapy ; Radiotherapy, Adjuvant ; Registries ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Urinary Bladder Neoplasms - epidemiology ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - surgery ; Young Adult</subject><ispartof>European journal of cancer (1990), 2016-02, Vol.54, p.18-26</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-fb024a7cc40497915739f632313afcee3fd7da98db575960887b2b0d802f2a203</citedby><cites>FETCH-LOGICAL-c411t-fb024a7cc40497915739f632313afcee3fd7da98db575960887b2b0d802f2a203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26707593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hermans, Tom J.N</creatorcontrib><creatorcontrib>Fransen van de Putte, Elisabeth E</creatorcontrib><creatorcontrib>Horenblas, Simon</creatorcontrib><creatorcontrib>Lemmens, Valery</creatorcontrib><creatorcontrib>Aben, Katja</creatorcontrib><creatorcontrib>van der Heijden, Michiel S</creatorcontrib><creatorcontrib>Beerepoot, Laurens V</creatorcontrib><creatorcontrib>Verhoeven, Rob H</creatorcontrib><creatorcontrib>van Rhijn, Bas W.G</creatorcontrib><title>Perioperative treatment and radical cystectomy for bladder cancer – a population based trend analysis of 10,338 patients in the Netherlands</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Abstract Background In Europe, population-based data concerning perioperative treatment (PT) and radical cystectomy (RC) are lacking. We assessed temporal trends in PT (neoadjuvant chemotherapy [NAC], neoadjuvant radiotherapy [NAR], adjuvant chemotherapy [AC], adjuvant radiotherapy [AR]) and RC in the Netherlands and identified patients' and hospital characteristics associated with PT. Methods This nationwide, retrospective, population-based study included cTa/is, T1-4, N0-3, M0-1 bladder cancer patients from the Netherlands Cancer Registry who underwent RC with curative intent between 1995 and 2013. PT-administration over time was compared with chi-square tests. Multivariable logistic regression analyses were performed to identify characteristics associated with PT usage. The sub-groups cT2-4N0M0 and cT2-4, N0 or NX, M0 or MX were separately analysed. Results In total, 10,338 patients met inclusion criteria. Eighty-six percent did not receive PT, 7.0% received NAC (or induction chemotherapy [IC]), 3.2% NAR, 1.8% AC, and 2.1% AR. NAC usage increased from 0.6% in 1995 to 21% in 2013 (p < 0.001), application of NAR decreased from 15% to 0.4% (p < 0.001). Usage of AC and AR in 2013 was <1.5%. Comparable temporal trends were found in 6032 patients staged cT2-4N0M0. Multivariable logistic regression analysis revealed that younger age, ≥cT3, ≥cN1 and treatment in academic/teaching hospitals were associated with NAC or IC (all p < 0.05). Conclusions The increase in NAC administration in the Netherlands reflects a slow but steady adoption of evidence-based guidelines over the last two decades. Considerable variability in patients' and hospital characteristics in the likelihood of receiving NAC exists. Conversely, NAR, AR and AC are hardly administered anymore.</description><subject>Adjuvant</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Bladder</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cystectomy</subject><subject>Cystectomy - trends</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hospitals, Teaching</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoadjuvant</subject><subject>Neoadjuvant Therapy - trends</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Staging</subject><subject>Netherlands - epidemiology</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Urinary Bladder Neoplasms - epidemiology</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Young Adult</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9UrGO1TAQtBCIe3fwAxTIJQUJazuJHQkhoRMHSCdAAmrLsTfCIS8OdnJSOn6Aij_kS3D0DgoKGm8zM-uZWUIeMSgZsObZUOJgTcmB1SVjJUBzhxyYkm0BquZ3yQHaui0UVO0ZOU9pAACpKrhPzngjQdatOJAfHzD6MGM0i79BukQ0yxGnhZrJ0Wict2akdksL2iUcN9qHSLvROIeRWjPZPH59_0kNncO8jlkkTLQzCd0ulSXMZMYt-URDTxk8FULROaPyhkT9RJcvSN9hfuOYF6YH5F5vxoQPb-cF-Xz16tPlm-L6_eu3ly-vC1sxthR9B7wy0toqe5Mtq6Vo-0ZwwYTpLaLonXSmVa6rs8sGlJId78Ap4D03HMQFeXLSnWP4tmJa9NEni2P-BIY1aSYbLqocsspQfoLaGFKK2Os5-qOJm2ag9xr0oPca9F6DZkznGjLp8a3-2h3R_aX8yT0Dnp8AmF3eeIw62RyKRedjTlq74P-v_-Ifuh39tHf1FTdMQ1hjzj370Ilr0B_3Q9jvgNXAQDSt-A1hvq-R</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Hermans, Tom J.N</creator><creator>Fransen van de Putte, Elisabeth E</creator><creator>Horenblas, Simon</creator><creator>Lemmens, Valery</creator><creator>Aben, Katja</creator><creator>van der Heijden, Michiel S</creator><creator>Beerepoot, Laurens V</creator><creator>Verhoeven, Rob H</creator><creator>van Rhijn, Bas W.G</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Perioperative treatment and radical cystectomy for bladder cancer – a population based trend analysis of 10,338 patients in the Netherlands</title><author>Hermans, Tom J.N ; Fransen van de Putte, Elisabeth E ; Horenblas, Simon ; Lemmens, Valery ; Aben, Katja ; van der Heijden, Michiel S ; Beerepoot, Laurens V ; Verhoeven, Rob H ; van Rhijn, Bas W.G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-fb024a7cc40497915739f632313afcee3fd7da98db575960887b2b0d802f2a203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adjuvant</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Bladder</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cystectomy</topic><topic>Cystectomy - trends</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hospitals, Teaching</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoadjuvant</topic><topic>Neoadjuvant Therapy - trends</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Staging</topic><topic>Netherlands - epidemiology</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Urinary Bladder Neoplasms - epidemiology</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hermans, Tom J.N</creatorcontrib><creatorcontrib>Fransen van de Putte, Elisabeth E</creatorcontrib><creatorcontrib>Horenblas, Simon</creatorcontrib><creatorcontrib>Lemmens, Valery</creatorcontrib><creatorcontrib>Aben, Katja</creatorcontrib><creatorcontrib>van der Heijden, Michiel S</creatorcontrib><creatorcontrib>Beerepoot, Laurens V</creatorcontrib><creatorcontrib>Verhoeven, Rob H</creatorcontrib><creatorcontrib>van Rhijn, Bas W.G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hermans, Tom J.N</au><au>Fransen van de Putte, Elisabeth E</au><au>Horenblas, Simon</au><au>Lemmens, Valery</au><au>Aben, Katja</au><au>van der Heijden, Michiel S</au><au>Beerepoot, Laurens V</au><au>Verhoeven, Rob H</au><au>van Rhijn, Bas W.G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative treatment and radical cystectomy for bladder cancer – a population based trend analysis of 10,338 patients in the Netherlands</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>54</volume><spage>18</spage><epage>26</epage><pages>18-26</pages><issn>0959-8049</issn><eissn>1879-0852</eissn><abstract>Abstract Background In Europe, population-based data concerning perioperative treatment (PT) and radical cystectomy (RC) are lacking. We assessed temporal trends in PT (neoadjuvant chemotherapy [NAC], neoadjuvant radiotherapy [NAR], adjuvant chemotherapy [AC], adjuvant radiotherapy [AR]) and RC in the Netherlands and identified patients' and hospital characteristics associated with PT. Methods This nationwide, retrospective, population-based study included cTa/is, T1-4, N0-3, M0-1 bladder cancer patients from the Netherlands Cancer Registry who underwent RC with curative intent between 1995 and 2013. PT-administration over time was compared with chi-square tests. Multivariable logistic regression analyses were performed to identify characteristics associated with PT usage. The sub-groups cT2-4N0M0 and cT2-4, N0 or NX, M0 or MX were separately analysed. Results In total, 10,338 patients met inclusion criteria. Eighty-six percent did not receive PT, 7.0% received NAC (or induction chemotherapy [IC]), 3.2% NAR, 1.8% AC, and 2.1% AR. NAC usage increased from 0.6% in 1995 to 21% in 2013 (p < 0.001), application of NAR decreased from 15% to 0.4% (p < 0.001). Usage of AC and AR in 2013 was <1.5%. Comparable temporal trends were found in 6032 patients staged cT2-4N0M0. Multivariable logistic regression analysis revealed that younger age, ≥cT3, ≥cN1 and treatment in academic/teaching hospitals were associated with NAC or IC (all p < 0.05). Conclusions The increase in NAC administration in the Netherlands reflects a slow but steady adoption of evidence-based guidelines over the last two decades. Considerable variability in patients' and hospital characteristics in the likelihood of receiving NAC exists. Conversely, NAR, AR and AC are hardly administered anymore.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26707593</pmid><doi>10.1016/j.ejca.2015.11.006</doi><tpages>9</tpages></addata></record> |
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| subjects | Adjuvant Adolescent Adult Age Factors Aged Bladder Cancer Chemotherapy Chemotherapy, Adjuvant Child Child, Preschool Cystectomy Cystectomy - trends Female Hematology, Oncology and Palliative Medicine Hospitals, Teaching Humans Infant Infant, Newborn Logistic Models Male Middle Aged Multivariate Analysis Neoadjuvant Neoadjuvant Therapy - trends Neoplasm Grading Neoplasm Staging Netherlands - epidemiology Practice Patterns, Physicians' - trends Radiotherapy Radiotherapy, Adjuvant Registries Retrospective Studies Time Factors Treatment Outcome Urinary Bladder Neoplasms - epidemiology Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - surgery Young Adult |
| title | Perioperative treatment and radical cystectomy for bladder cancer – a population based trend analysis of 10,338 patients in the Netherlands |
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