Hepatocellular carcinoma in the Netherlands incidence, treatment and survival patterns

To examine recent trends of hepatocellular carcinoma (HCC) in an unselected patient population in the Western world, cancer registration data of HCC in the Netherlands were analysed. Trends in incidence, mortality, treatment and survival, according to gender, age, stage of disease and period of diagnosis were studied. Age-standardised incidence of HCC in the Netherlands did not rise from 1989 to 2000. In men older than 75 years, there was a significant increase. Mortality due to primary liver cancer increased from 1989 to 2000. There was no change in the treatment pattern (1989-1998), whereas 73% of patients with HCC received no cancer-related therapy during this period of analysis. Twelve percent of the patients underwent either a partial liver resection or orthotopic liver transplantation. This low percentage suggests that patients with HCC must be analysed and discussed in specialised centres to minimise the number of patients not receiving possible curative therapy.