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Variation in diagnosis, treatment and outcome in colon and rectal cancer

Elferink, M.A.G.

Citation

Elferink, M. A. G. (2011, September 7). Variation in diagnosis, treatment and outcome in colon and rectal cancer. Retrieved from

https://hdl.handle.net/1887/17818

Version: Corrected Publisher’s Version

License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the

University of Leiden

Downloaded from: https://hdl.handle.net/1887/17818

Note: To cite this publication please use the final published version (if

applicable).

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Variation in diagnosis,

treatment and outcome

in colon and rectal cancer

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Marloes-1-intro_stramien 28-06-11 09:29 Pagina 2

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Variation in diagnosis, treatment and outcome in colon and rectal cancer

PROEFSCHRIFT

ter verkrijging van

de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof. mr. P.F. van der Heijden,

volgens besluit van het College voor Promoties te verdedigen op woensdag 7 september 2011

klokke 11.15 uur

door

Marloes Anne Gertrude Elferink geboren te Tubbergen

in 1981

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Promotiecommissie

Promotoren prof. dr. R.A.E.M. Tollenaar

prof. dr. J.A. Langendijk (Universitair Medisch Centrum Groningen) Co-promotor dr. S. Siesling (Integraal Kankercentrum Nederland)

Overige leden dr. R. Otter (Integraal Kankercentrum Nederland)

prof. dr. J.H.J.M. van Krieken (Universitair Medisch Centrum Nijmegen) prof. dr. H. Struikmans

prof. dr. C.J.H. van de Velde Marloes-1-intro_stramien 28-06-11 09:29 Pagina 4

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Contents

1. Introduction 7

2. Trends in treatment and survival 19

2.1 Marked improvements in survival of patients with rectal cancer in

the Netherlands following changes in therapy, 1989-2006 21 2.2 Improved survival of colon cancer due to improved treatment and

detection: a nationwide population-based study in the Netherlands

1989-2006 39

2.3 Prognostic factors for locoregional recurrences in colon cancer 57

3. Variation in lymph node evaluation 75

3.1 Variation in lymph node evaluation in rectal cancer, a Dutch nationwide

population-based study 77

3.2 Large variation between hospitals and pathology laboratories in lymph node evaluation in colon cancer and its impact on survival, a nationwide

population-based study in the Netherlands 95

4. Variation in treatment and outcome 113

4.1 Variation in treatment and outcome in patients with rectal cancer by

hospital type and volume in the Netherlands 115

4.2 Disparities in quality of care for colon cancer between hospitals in

the Netherlands 135

5. Discussion 157

Summary 175

Samenvatting 179

Dankwoord 184

Publication list 186

Curriculum Vitae 188

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Colofon

Variation in diagnosis, treatment and outcome in colon and rectal cancer

© 2011 Marloes Elferink

All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording or otherwise, without written permission of the author.

ISBN/EAN

978-90-9026167-6

Lay-out

Gery Hoekstra, Comprehensive Cancer Centre the Netherlands

Printed by

Grafische Industrie De Marne, Leens, the Netherlands

This thesis was financial supported by

Comprehensive Cancer Centre the Netherlands (Integraal Kankercentrum Nederland) Marloes-1-intro_stramien 28-06-11 09:29 Pagina 6

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