title: Gallbladder cancer in the Netherlands: incidence, treatment and survival patterns since 1989.
abstract: BACKGROUND
  To examine recent trends in gallbladder cancer (GBC) in the general population in the Western world, cancer registration data on GBC in the Netherlands were analyzed.
  
  
  METHODS
  Trends in incidence, treatment and survival, according to gender, age and stage of disease, between 1989 and 2008 for 3,917 patients were studied. Rates were age-standardized to the European standard population (European Standardized Rates - ESR).
  
  
  RESULTS
  The incidence rate for GBC in the Netherlands decreased rapidly during the period of 1989-2008, except for males younger than 60 years. Overall survival remained stable, short-term (3-month) and long-term (5-year) relative survival among surgically treated patients increased significantly. Treatment patterns for GBC changed. Surgery decreased from 55% in 1989 to 38% in 2008 (p < 0.001). Chemotherapy and/or irradiation increased from 1.0 to 5.8% (p < 0.001). Receiving best supportive care increased from 44% in 1989 to 57% in 2008 (p < 0.001).
  
  
  CONCLUSIONS
  The incidence rate for GBC in the Netherlands has decreased rapidly. Treatment patterns for GBC have changed and survival among surgically treated patients has increased.
authors.affiliation: Department of Hepatobiliary and Transplantation Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. c.witjes@erasmusmc.nl
authors.forename: Caroline D M
authors.initials: CD
authors.lastname: Witjes
authors.forename: Sanne A W
authors.initials: SA
authors.lastname: van den Akker
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
authors.forename: Henrike E
authors.initials: HE
authors.lastname: Karim-Kos
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.forename: Robert A
authors.initials: RA
authors.lastname: de Man
authors.forename: Jan Willem W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: Cornelis
authors.initials: C
authors.lastname: Verhoef
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D002763:Cholecystectomy / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome