Trends in resection rates and postoperative mortality for gastrointestinal cancers between 2005 and 2020 in the Netherlands

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2025-04-25 DOI:10.1016/j.ejca.2025.115469

Quince M.M.A. Timmermans , Ignace H.J.T. de Hingh , Marloes A.G. Elferink , Bas P.L. Wijnhoven , Erik J. Schoon , Johannes H.W. de Wilt , Lydia G.M. van der Geest , Pauline A.J. Vissers

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Abstract

Aim

This study assesses trends in resection rates and postoperative mortality for oesophageal, gastric, colon, rectal, periampullary and pancreatic cancer in the Netherlands.

Methods

This retrospective cohort study included all patients with gastrointestinal cancer diagnosed in the period 2005–2020 as registered in the Netherlands Cancer Registry. Cochran-Armitage trend tests were used to assess trends in resection rates. Multivariable logistic regression analyses were used to assess the association between time period and resection rates and postoperative mortality and were stratified for nonmetastatic versus metastatic disease at initial diagnosis.

Results

A total of 226 925 patients with nonmetastatic and 92 343 with metastatic disease were included. A lower likelihood of undergoing resection was observed for patients diagnosed between 2017 and 2020 as compared to 2005–2008 for nonmetastatic colon (OR=0.73; 95 %CI:0.68–0.79) and rectal cancer (OR=0.44; 95 %CI:0.40–0.48). In contrast, higher resection rates were observed for nonmetastatic gastric (OR=1.17; 95 %CI:1.03–1.32), periampullary (OR=2.44;95 %CI:2.09–2.84) and pancreatic cancer (OR=2.81; 95 %CI:2.51–3.15 comparing the same time periods). Patients with nonmetastatic disease diagnosed in 2017–2020 had a lower likelihood of 90-day postoperative mortality compared to 2005–2008 for all cancer types with ORs ranging between 0.27 (95 %CI:0.22–0.33, rectal cancer) and 0.60 (95 %CI:0.43–0.84, periampullary cancer). In colon and rectal cancer patients presenting with metastatic disease, resection rates and postoperative mortality significantly decreased over time.

Conclusion

Resection rates decreased for some gastrointestinal cancer types possibly due to the introduction of treatment strategies without resection (e.g. watchful waiting). Postoperative mortality decreased for all patients, possibly as a result of increased quality of care, and improved patient selection.

查看原文本刊更多论文

2005年至2020年间荷兰胃肠道癌的切除率和术后死亡率趋势

目的：本研究评估荷兰食管癌、胃癌、结肠癌、直肠癌、壶腹周围癌和胰腺癌的切除率和术后死亡率趋势。方法本回顾性队列研究纳入了2005-2020年期间在荷兰癌症登记处登记的所有诊断为胃肠道癌症的患者。Cochran-Armitage趋势试验用于评估切除率的趋势。多变量logistic回归分析用于评估时间、切除率和术后死亡率之间的关系，并在初始诊断时对非转移性和转移性疾病进行分层。结果共纳入非转移性226 925例，转移性92 343例。与2005-2008年相比，2017年至2020年诊断为非转移性结肠的患者接受切除术的可能性较低(OR=0.73；95 %CI: 0.68-0.79)和直肠癌(OR=0.44；95 %置信区间:0.40—-0.48)。相比之下，非转移性胃癌的切除率更高(OR=1.17；95 %CI: 1.03-1.32)、壶腹周围癌（OR=2.44;95 %CI: 2.09-2.84）和胰腺癌(OR=2.81；95 %CI: 2.51-3.15比较同一时期)。与2005-2008年相比，2017-2020年诊断的非转移性疾病患者术后90天死亡率的可能性较低，所有癌症类型的or范围为0.27（95 %CI: 0.22-0.33，直肠癌）和0.60（95 %CI: 0.43-0.84，壶腹周围癌）。在出现转移性疾病的结肠癌和直肠癌患者中，切除率和术后死亡率随着时间的推移显著降低。结论部分胃肠道肿瘤的切除率下降，可能与不切除治疗策略（如观察等待）的引入有关。所有患者的术后死亡率均有所下降，这可能是由于护理质量的提高和患者选择的改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.