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Previous studies have shown that older patients benefited less than younger patients from surgical treatment for colorectal cancer (CRC). However, CRC care has advanced over time, and it is time to assess whether the difference in postoperative mortality between older and younger CRC patients is still present. Patients with primary stage I-III CRC diagnosed between 2005 and 2016 were selected from the Netherlands Cancer Registry (N = 111,778). Trends in postoperative mortality and 1-year postoperative relative survival (RS) were analysed, stratified according to age (<75 versus ≥75 years) and tumour location (colon versus rectum). One-year postoperative RS was analysed to correct for background mortality in the older population. Between 2005 and 2016, 30-day postoperative mortality showed a stronger decrease for older patients (from 10.0% to 4.0% for colon cancer [p < 0.001] and from 8.3% to 2.7% for rectal cancer [p < 0.001]) compared with younger patients (from 2.0% to 0.9% for colon cancer [p < 0.001] and from 1.4% to 0.7% for rectal cancer [p = 0.01]). Between 2005 and 2016, also 1-year RS increased more for older patients (from 84.8% to 94.6% for colon cancer and from 86.1% to 97.2% for rectal cancer) compared with younger patients (from 94.0% to 97.8% for colon cancer and from 96.3% to 98.8% for rectal cancer). Between 2005 and 2016, differences in postoperative mortality between older and younger CRC patients decreased. One-year postoperative RS was almost equal for older and younger patients in 2015–2016. This information is crucial for shared decision-making on surgical treatment. • Differences in mortality between older and younger CRC patients decreased. • One-year relative survival became nearly equal for older and younger patients. • Previous literature is no longer representative of the current clinical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVES: In the Netherlands, surgery for lung cancer is traditionally performed in low-volume hospitals. To assess the need for centralization, we examined early outcome measures and compared results between hospitals and with other European countries. METHODS: Data on patient, tumour and treatment characteristics were retrieved from the Netherlands Cancer Registry. Results were tabulated for 30-day postoperative mortality (POM), major morbidity rate (intrathoracic empyema, bronchopleural fistula or rethoracotomy) and pneumonectomy proportion. Hospital variation was projected using funnel graphs in which the results for individual hospitals are plotted against volume. RESULTS: The study comprised a series of 9579 patients with primary non-small cell lung cancer, diagnosed from 2005 through 2010 and operated in 79 different hospitals. The POM was 2.7% on average and age, gender, period and type of surgery were determined as prognostic factors. Multivariable analysis did not reveal an association with hospital volume (P = 0.34). The POM was higher for operations on Fridays (4.0%) or during weekends (6.8%). Major morbidity was observed after 8.3% of operations and was more frequent after bilobectomy (11.6%) or right pneumonectomy (22%). The pneumonectomy proportion decreased from 18% in 2005 to 11% in 2010. Funnel plots revealed a limited number of significant outliers, despite combining data over a 6-year period. CONCLUSIONS: Results for the Netherlands were similar to those from other European countries. Hospital volume was not associated with early outcome indicators. Quality assessment at the hospital level remains a major challenge given the low frequency of adverse events and the impediments of chance variation. [ABSTRACT FROM AUTHOR]

Abstract: Residual disease after cytoreductive surgery is an important prognostic factor in patients with advanced stage epithelial ovarian cancer (EOC). Aggressive surgical procedures necessary to achieve maximal cytoreduction are inevitably associated with postoperative morbidity and mortality. To determine causes of postoperative mortality (POM) after surgery for EOC all postoperative deaths in the southwestern part of the Netherlands over a 17-year period were identified and analysed by reviewing medical notes. Between 1989 and 2005, 2434 patients underwent cytoreductive surgery for EOC. Sixty-seven patients (3.1%) died within 30 days after surgery. Postoperative mortality increased with age from 1.5% (26/1765) for the age group 20–69 to 6.6% (32/486) for the age group 70–79 and 9.8% (18/183) for patients aged 80 years or older. Pulmonary failure (18%) and surgical site infection (15%) were the most common causes of death. Only a quarter of deaths resulted from surgical site complications. Our results suggest that causes of postoperative mortality after surgery for EOC are very heterogeneous. Given the impact of general complications, progress in preoperative risk assessment, preoperative preparation and postoperative care seem essential to reduce the occurrence of fatal complications. [Copyright &y& Elsevier]

Background: Worse prognosis in elderly colorectal cancer (CRC) patients may be cancer or treatment related, or death from other causes. This population-based study aimed to compare survival among non-metastatic CRC patients between age groups and notice time trends in mortality rates., Methods: Primary stage I-III CRC patients who underwent resection between 2008 and 2013 were selected from the Netherlands Cancer Registry. Patients were divided into three equally distributed age groups and a separated group including the oldest old (<65, 65-74, 75-84 and ≥ 85 years). Survival rates were calculated by age groups and tumour localization. Relative excess risks of death, 30-day, 1-year mortality and 1-year excess mortality were calculated., Results: 52296 patients were included. Age-related differences in 5-year overall survival were observed (colon cancer: 82%, 73%, 56% and 35%; rectal cancer: 82%, 74%, 56% and 38%; p < 0.0001). Age-related differences were less prominent in relative survival and disappeared in conditional relative survival (condition of surviving 1 year). Thirty-day mortality rates decreased over time (colon cancer: 4.9%-3.4%; rectal cancer: 3.0%-1.7%); 1-year mortality rates decreased from 11.9% to 9.6% in colon cancer and from 8.0% to 6.4% in rectal cancer. One-year excess mortality increased with age (17.3% and 12.9% in patients with colon or rectal cancer aged ≥85 years)., Conclusion: One-year mortality rates remain high in elderly patients. Age-related differences in survival disappeared after adjustment for expected death from other causes and first-year mortality. Beneficial time trends in 1-year mortality rates underline that survival in elderly after CRC surgery is modifiable., (Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Studies investigating perioperative chemotherapy and/or radiotherapy changed the treatment of curable gastric cancer in The Netherlands. These changes were evaluated including their influence on survival. Data on patients diagnosed with gastric cancer from 1989 to 2009 were obtained from The Netherlands Cancer Registry. Changes over time in surgery and administration of perioperative chemotherapy, 30-day mortality, 5-year survival and adjusted relative excess risk (RER) of dying were analyzed with multivariable regression for cardia and noncardia cancer. In stages I and II disease, most patients underwent surgery. Since 2005, more patients are treated with (neo)adjuvant chemotherapy. Postoperative mortality ranged from 1% to 7% and 0.4% to 12.2% in cardia and noncardia cancer (<55 to 75+ years). Five-year survival for cardia cancer and noncardia cancer stages I-III and X (unknown stage) was 33% and 50% (2005-2008). The RER of dying was associated with period of diagnosis, age, gender, region, stage, (neo)adjuvant chemotherapy in case of cardia cancer and type of gastric resection in case of noncardia cancer. Administration of (neo)adjuvant chemotherapy has increased. No improvement in long-term survival could yet be seen, though it is still too early to expect an improvement in survival as a result of the use of chemotherapy., (Copyright © 2013 UICC.)