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Amsterdam-Zuidoost, Netherlands

Asadzadeh Vostakolaei F.,Radboud University Nijmegen | Karim-Kos H.E.,Erasmus University Rotterdam | Janssen-Heijnen M.L.G.,Comprehensive Cancer Center South | Visser O.,Comprehensive Cancer Center Amsterdam | And 3 more authors.
European Journal of Public Health

Background: The complement of the cancer mortality to incidence ratio [1-(M/I)] has been suggested as a valid proxy for 5-year relative survival. Whether this suggestion holds true for all types of cancer has not yet been adequately evaluated. Methods: We used publicly available databases of cancer incidence, cancer mortality and relative survival to correlate relative survival estimates and 1-(M/I) estimates from Denmark, Finland, Iceland, Norway, Sweden, the USA and the Netherlands. We visually examined for which tumour sites 5-year relative survival cannot simply be predicted by the 1-(M/I) and evaluated similarities between countries. Results: Country-specific linear regression analyses show that there is no systematic bias in predicting 5-year relative survival by 1-(M/I) in five countries. There is a small but significant systematic underestimation of survival from prognostically poor tumour sites in two countries. Furthermore, the 1-(M/I) overestimates survival from oral cavity and liver cancer with >10 in at least two of the seven countries. By contrast, the proxy underestimates survival from soft tissue, bone, breast, prostate and oesophageal cancer, multiple myeloma and leukaemia with >10 in at least two of the seven countries. Conclusion: The 1-(M/I) is a good approximation of the 5-year relative survival for most but not all tumour sites. © The Author 2010. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. Source

Schaapveld M.,Comprehensive Cancer Center Amsterdam | Schaapveld M.,Netherlands Cancer Institute | Visser O.,Comprehensive Cancer Center Amsterdam | Siesling S.,Comprehensive Cancer Center North East | And 3 more authors.
European Journal of Cancer

This study assesses whether new treatment strategies developed in clinical trials translate into improved survival for multiple myeloma (MM) patients in the Netherlands. All patients diagnosed with MM in the Northern part of the Netherlands between 1989 and 2005 were retrieved from two regional population-based cancer registries. Information on study participation was derived from linkage with trial information systems. The effect of period of diagnosis (1989-1992, 1993-1996, 1997-2000, 2001-2005), age (<50, 50-65, 66-74, ≥75), gender, Salmon-Durie (SD) stage, trial participation and treatment on relative survival were studied. In total 4985 patients were included. When trial participation was analysed for exact periods in which trials were open, 16% of patients aged ≤65 years with SD-stage I and 38% with SD-stage II or III were enrolled compared to 2% of patients aged >65 years with SD-stage I and 5% with SD-stage II or III. Relative survival decreased with age (p < .001), with advanced stage (p < .001) and was better for patients enrolled in trials (p < .001). Five-year relative survival increased from 34% (95% confidence interval (95% CI) 28-39%) in 1989-1992 to 56% (95% CI 50-61%) in 2001-2005 for patients ≤65 years. The excess mortality was 37% lower in 2001-2005 than in 1989-1992 for these patients, adjusted for age, stage, trial participation and gender (p < .001). Survival did not improve for older patients. In conclusion: MM survival improved among younger but not among older patients since the mid-1990s. The improved survival of younger patients coincided with increasing trial participation and increasing use of high-dose chemotherapy and autologous stem-cell transplantation. © 2009 Elsevier Ltd. All rights reserved. Source

Bantema-Joppe E.J.,University of Groningen | De Munck L.,Comprehensive Cancer Center North East | Visser O.,Comprehensive Cancer Center Amsterdam | Willemse P.H.B.,University of Groningen | And 4 more authors.
International Journal of Radiation Oncology Biology Physics

Purpose: In young women, breast-conserving therapy (BCT), i.e., lumpectomy followed by radiotherapy, has been associated with an increased risk of local recurrence. Still, there is insufficient evidence that BCT impairs survival. The aim of our study was to compare the effect of BCT with mastectomy on overall survival (OS) in young women with early-stage breast cancer. Methods and Materials: From two Dutch regional population-based cancer registries (covering 6.2 million inhabitants) 1,453 women <40 years with pathologically T1N0-1M0 breast cancer were selected. Cox regression survival analysis was used to study the effect of local treatment (BCT vs. mastectomy) stratified for nodal stage on survival and corrected for tumor size, age, period of diagnosis, and use of adjuvant systemic therapy. Results: With a median follow-up of 9.6 years, 10-year OS was 83% after BCT and 78% after mastectomy, respectively (unadjusted hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.09-1.72). In N0-patients, 10-year OS was 84% after BCT and 81% after mastectomy and local treatment was not associated with differences in OS (HR 1.19; 95% CI, 0.89-1.58; p = 0.25). Within the N1-patient group, OS was better after BCT compared with mastectomy, 79% vs. 71% at 10 years (HR 1.91; 95% CI, 1.28-2.84; p = 0.001) and in patients treated with adjuvant hormonal therapy (HR 0.34; 95% CI, 0.18-0.66; p = 0.001). Conclusions: In this large population-based cohort of early-stage young breast cancer patients, 10-year OS was not impaired after BCT compared with mastectomy. Patients with 1 to 3 positive lymph nodes had better prognosis after BCT than after mastectomy. © 2011 Elsevier Inc. Source

Mook S.,Netherlands Cancer Institute | Van 'T Veer L.J.,Netherlands Cancer Institute | Rutgers E.J.,Netherlands Cancer Institute | Ravdin P.M.,University of Texas Health Science Center at San Antonio | And 4 more authors.
Journal of the National Cancer Institute

BackgroundMammographic screening has led to a proportional shift toward earlier-stage breast cancers at presentation. We assessed whether the method of detection provides prognostic information above and beyond standard prognostic factors and investigated the accuracy of predicted overall and breast cancer-specific survival by the computer tool Adjuvant! among patients with screen-detected, interval, and nonscreening-related carcinomas.MethodsWe studied 2592 patients with invasive breast cancer who were treated at the Netherlands Cancer Institute from January 1, 1990, through December 31, 2000. Overall and breast cancer-specific survival probabilities among patients with mammographically screen-detected (n = 958), interval (n = 417), and nonscreening-related (n = 1217) breast carcinomas were compared. Analyses were adjusted for clinicopathologic characteristics and adjuvant systemic therapy. Because of gradual implementation of population-based screening in the Netherlands, analyses were stratified a priori according to two periods of diagnosis. All statistical tests were two-sided.ResultsScreen detection was associated with reduced mortality (adjusted hazard ratio for all-cause mortality = 0.74, 95% confidence interval = 0.63 to 0.87, P <. 001, and adjusted hazard ratio for breast cancer-specific mortality = 0.62, 95% confidence interval = 0.50 to 0.78, P <. 001, respectively) compared with nonscreening-related detection. The absolute adjusted reduction in breast cancer-specific mortality was 7% at 10 years. The prognostic value of the method of detection was independent of the period of diagnosis and was similar across tumor size and lymph node status categories, indicating its prognostic value beyond stage migration. Adjuvant! underestimated breast cancer-specific survival in patients with screen-detected (-3.2%) and interval carcinomas (-5.4%).ConclusionsScreen detection was found to be independently associated with better prognosis for overall and breast cancer-specific survival and to provide prognostic information beyond stage migration among patients with invasive breast cancer. We propose that the method of detection should be taken into account when estimating individual prognosis. © 2011 The Author. Source

Reichgelt B.A.,Netherlands Cancer Institute | Reichgelt B.A.,Leiden University | Visser O.,Comprehensive Cancer Center Amsterdam
European Journal of Cancer

Background: Merkel cell carcinoma (MCC) is a rare and highly malignant neuroendocrine tumour, predominantly located on sun-exposed areas of the skin. The aim of this study was to evaluate data in the Netherlands concerning incidence, stage, age, sex, location, treatment and survival. Methods: Using nationwide data from the Netherlands Cancer Registry from 1993 to 2007, we compared 808 MCCs with European data and the US Surveillance, Epidemiology and End Results (SEER) Program. Results: The annual age standardised incidence rate per million of MCC increased from 1.7 in 1993-1997 to 3.5 in 2003-2007. Median age at diagnosis was 76 years. The most common location was the head and neck. Three quarters of patients had localised disease, 16% regional and 6% distant metastasis. Surgery was performed in 89% of patients, with adjuvant radiotherapy in 26% of them. One-, five- and ten-year relative survival was 85%, 62% and 47%, respectively. Negative predictive factors for the risk of death were male sex, increasing T-stage, regional and distant metastasis and no treatment. Survival after combined surgery and radiotherapy was borderline significantly better than surgery alone (HR 0.82, p = 0.09). Our results are comparable to SEER data except for the ratio localised/regional disease. We observed less regional cases (16% versus 31%); while ten-year survival of localised cases was lower (51% versus 71%). Conclusions: MCC incidence rates have doubled in the Netherlands over the period 1993-2007. The relatively high number of localised cases and their relatively low survival as compared to SEER data suggest that a substantial proportion is undertreated. © 2011 Published by Elsevier Ltd. Source

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