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Aim: To describe the population-based variation in treatment policies and outcome for bladder cancer in the Netherlands.
Methods: All newly diagnosed patients with primary bladder cancers during 2001-2006 were selected from the Netherlands Cancer Registry (n = 29,206). Type of primary treatment was analysed according to Comprehensive Cancer Centre region, hospital type (academic, non-academic teaching or other hospitals) and volume (≤5, 6-10 or >10 cystectomies yearly). For stage II-III patients undergoing cystectomy we analysed the proportion of lymph node dissections and 30-days mortality.
Results: 44% of patients with stage II-III bladder cancer underwent cystectomy, while 26% were not treated with curative intent. Cystectomy was the preferred option in three of nine regions, radiotherapy in two, and two regions waived curative treatment more often. Between 2001 and 2006 the number of cystectomies increased with 20% (n = 108). 21% (n = 663) of these procedures were performed in 44 low volume hospitals. In 79% of the cystectomies lymph node dissections were performed, more often in high and medium-volume centers (82% and 81% respectively) than in low-volume hospitals (71%, the odds ratio being 1.5). The overall 30-days postoperative mortality rate was 3.4% and increased with older age. It was significantly lower in high-volume centers (1.2%).
Conclusion: Treatment policies for muscle-invasive bladder cancer in the Netherlands showed regional preferences and a gradual increase of cystectomy. Cystectomy albeit considered as golden standard, was performed in a minority of the muscleinvasive cases. In high-volume institutions, lymph node dissection rates were higher and post-operative mortality rates were lower.
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The Netherlands Cancer Registry. Incidence of invasive tumors, specified for sex and localisation for year of incidence (1989–2007). Available from: www.ikcnet.nl/page.php?nav_id = 41& id = 2863. 1–1-2009.
Ferlay J, Randi G, Bosetti C, Levi F, Negri E, Boyle P, La VC. Declining Mortality From Bladder Cancer in Europe. BJU Int. 2008;101(1):11–9. PubMed
Batterman JJ, Feller N, Hamelers-Paulus HWG, Reijke TM de, Witjes JA. Guideline Diagnostics, treatment and follow-up of the Urothelial Cell Carcinoma of the bladder. 2008, Dutch Projectgroep Guideline Bladder Cancer; the Netherlands Cancer Registry.
van Heek NT, Kuhlmann KF, Scholten RJ, Castro SM de, Busch OR, Gulik TM van, Obertop H, Gouma DJ. Hospital Volume and Mortality After Pancreatic Resection: a Systematic Review and an Evaluation of Intervention in the Netherlands. Ann Surg. 2005;242(6):781–8, discussion.
Fritz A. International Classification of Diseases for Oncology. Geneva: World Health Organization; 2000.
Sobin LH, Wittekind C. TNM Classification of Malignant Tumours. 6th ed. New York: Wiley-Liss; 2002.
Hall MC, Chang S, Dalbagni G, Pruthi RS, Schellhammer PF, Seigne JD, Skinner EC, Wolf JS, Bell HS, Florer PM, Glickham D, Pope S, Hubbard H, Budd E, Folmer M, Moore K, Kebe K. Management of Nonmuscle Invasive Bladder Cancer: (Stages Ta,T1, and Tis): Revised (2007). 10–1-2007. American Urological Association Education and Research, Inc.
Jakse G, Algaba F, Fossa S, Stenzyl A, Sternberg C. Guidelines on bladder cancer, muscle-invasive and metastatic. European association of Urology; 2006.
de Vries RR, Visser O, Nieuwenhuijzen JA, Horenblas S. Outcome of Treatment of Bladder Cancer: a Comparison Between Low-Volume Hospitals and an Oncology Centre. World J Urol. 2010.
Goossens-Laan C, Kil P, Oudshoorn F, Roukema A, Bosch R, Vries J de. Quality of Care Indicators for Muscle-Invasive Bladder Cancer. Urology. 74(4), S104–S105.
Nieuwenhuijzen JA, Vries RR de, Bex A, Poel HG van der, Meinhardt W, Antonini N, Horenblas S. Urinary diversions after cystectomy: the association of clinical factors, complications and functional results of four different diversions. Eur Urol. 2008 Apr;53(4):834–42, discussion 842–4.
de Vries RR, Visser O, Nieuwenhuijzen JA, Horenblas S; Members of the Urological Oncology Working Group of the Comprehensive Cancer Centre Amsterdam. Outcome of treatment of bladder cancer: a comparison between low-volume hospitals and an oncology centre. World J Urol. 2010 Aug;28(4):431–7.
- Variations in treatment policies and outcome for bladder cancer in the Netherlands
drs. C.A. Goossens-Laan
dr. O. Visser
drs. M.W.J.M. Wouters
dr. M.L.E.A. Jansen-Landheer
prof. dr. J.W. Coebergh
prof. dr. C.J.H. van de Velde
dr. M.C.C.M. Hulshof
dr. P.J.M. Kil
- Bohn Stafleu van Loghum