AIM To investigate the nationwide time trends in incidence and survival of oesophageal and gastric adenocarcinomas according to the Laurén classification (intestinal, diffuse and mixed type). METHODS All patients diagnosed in the Netherlands with oesophageal or gastric adenocarcinoma between 1989 and 2015 were included. A syntax was developed to determine the histological subtype based on pathology reports as archived in the Dutch pathology registry. These reports were linked to individual data from the Netherlands Cancer Registry. Relative survival was used to assess survival. RESULTS The histological subtype could be determined in 18.691 (84.1%) oesophageal and in 32.312 (83.5%) gastric adenocarcinomas. Among these, 79% were intestinal and 21% diffuse type in oesophageal cancers, compared to 55% intestinal and 44% diffuse type in gastric cancers. Relative median survival of intestinal type tumours was longer than that of diffuse type tumours, that is, 12.1 versus 9.4 months for oesophageal carcinomas, and 10.1 versus 7.6 months for gastric carcinomas, respectively. Between 1989 and 2015, the relative median survival of non-metastatic intestinal and diffuse type oesophageal adenocarcinoma improved from 12.0 to 30.0 months, and from 12.0 to 19.2 months, respectively. The same was true for intestinal type gastric carcinoma (from 22.8 to 27.6 months) but for diffuse type gastric carcinoma, the increase was less (from 16.8 to 18.0 months). CONCLUSION In this nationwide study, histological subtypes of oesophageal and gastric adenocarcinomas differed in incidence and survival times. These findings may call for a differentiated treatment approach.

中文翻译：

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1989年至2015年间，荷兰人进行了一项基于人群的食管和胃小肠和弥漫型腺癌研究。

目的根据劳伦分类法（肠型，弥漫型和混合型）调查全国范围内食管和胃腺癌的发病率和生存时间趋势。方法纳入1989年至2015年在荷兰诊断为食道或胃腺癌的所有患者。根据在荷兰病理学注册表中存档的病理学报告，开发了一种语法来确定组织学亚型。这些报告与荷兰癌症登记处的个人数据相关联。相对存活率用于评估存活率。结果可以在食管癌中确定18691例（84.1％）和32.312例（83.5％）胃腺癌的组织学亚型。其中，食管癌中有79％为肠道型，而21％为弥散型，相比于胃癌中55％的肠道和44％的弥漫型。肠型肿瘤的相对中位生存期长于弥散型肿瘤，即食管癌分别为12.1月和9.4个月，胃癌为10.1对7.6个月。在1989年至2015年之间，非转移性小肠和弥漫型食管腺癌的相对中位生存期分别从12.0个月提高到30.0个月和从12.0个月提高到19.2个月。肠型胃癌（22.8至27.6个月）也是如此，但弥漫型胃癌的增加较少（从16.8至18.0个月）。结论在这项全国性的研究中，食管和胃腺癌的组织学亚型在发病率和生存时间方面存在差异。