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The number of employees applying for a labour disability benefit due to whiplash has gradually decreased during the last 25 years in the Netherlands. The total number of applicants seems to stabilise around 30% of the number around the turn of the century. This is surprising given that the professional standards for social insurance physicians emphasise the importance of rehabilitation, while courts hardly ever judge in favour of benefit claimants. We investigate the underlying reasons for the changing statistics and make a recommendation on how social insurance physicians can best approach a claimant.

From 1977-1984, 56 patients with colon cancer adherent to other organs were operated. Twenty-three patients (41%) underwent palliative treatment without resection. The mean survival in this group was 6 months. In this retrospective study the results were analysed of 33 patients (59%) who underwent a resection with curative intent. Pathological staging was based on the Dukes, Astler & Coller classification. The 4-year survival rate was as follows: Dukes B 47%, Dukes C 29%, Dukes D 0%. The 4-year survival rate for the whole group was 33%. The postoperative morbidity and mortality were 6% and 3% respectively. Colon cancer with involvement of adjacent structures should not be regarded as an incurable Dukes D cancer: extended resection is indicated.