Abstract
Background:Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1-2% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA.Methods:We retrospectively analysed the characteristics and clinical courses of 205 SBA patients from 11 institutions in Japan between June 2002 and August 2013.Results:The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. In contrast, 47 patients (83.9%) with jejunoileal carcinoma were symptomatic. The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. Multivariate analysis revealed performance status 3-4, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS). Ten patients (18.5%) with stage IV disease were treated with a combination of resection of primary tumour, local treatment of metastasis, and chemotherapy; this group had a median OS of 36.9 months.Conclusions:Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival.
| Original language | English |
|---|---|
| Pages (from-to) | 1607-1613 |
| Number of pages | 7 |
| Journal | British Journal of Cancer |
| Volume | 117 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 21 2017 |
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Keywords
- adenocarcinoma
- small bowel
- small intestine
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
The characteristics and outcomes of small bowel adenocarcinoma : A multicentre retrospective observational study. / Sakae, Hiroyuki; Kanzaki, Hiromitsu; Nasu, Junichiro; Akimoto, Yutaka; Matsueda, Kazuhiro; Yoshioka, Masao; Nakagawa, Masahiro; Hori, Shinichiro; Inoue, Masafumi; Inaba, Tomoki; Imagawa, Atsushi; Takatani, Masahiro; Takenaka, Ryuta; Suzuki, Seiyu; Fujiwara, Toshiyoshi; Okada, Hiroyuki.
In: British Journal of Cancer, Vol. 117, No. 11, 21.11.2017, p. 1607-1613.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The characteristics and outcomes of small bowel adenocarcinoma
T2 - A multicentre retrospective observational study
AU - Sakae, Hiroyuki
AU - Kanzaki, Hiromitsu
AU - Nasu, Junichiro
AU - Akimoto, Yutaka
AU - Matsueda, Kazuhiro
AU - Yoshioka, Masao
AU - Nakagawa, Masahiro
AU - Hori, Shinichiro
AU - Inoue, Masafumi
AU - Inaba, Tomoki
AU - Imagawa, Atsushi
AU - Takatani, Masahiro
AU - Takenaka, Ryuta
AU - Suzuki, Seiyu
AU - Fujiwara, Toshiyoshi
AU - Okada, Hiroyuki
PY - 2017/11/21
Y1 - 2017/11/21
N2 - Background:Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1-2% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA.Methods:We retrospectively analysed the characteristics and clinical courses of 205 SBA patients from 11 institutions in Japan between June 2002 and August 2013.Results:The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. In contrast, 47 patients (83.9%) with jejunoileal carcinoma were symptomatic. The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. Multivariate analysis revealed performance status 3-4, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS). Ten patients (18.5%) with stage IV disease were treated with a combination of resection of primary tumour, local treatment of metastasis, and chemotherapy; this group had a median OS of 36.9 months.Conclusions:Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival.
AB - Background:Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1-2% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA.Methods:We retrospectively analysed the characteristics and clinical courses of 205 SBA patients from 11 institutions in Japan between June 2002 and August 2013.Results:The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. In contrast, 47 patients (83.9%) with jejunoileal carcinoma were symptomatic. The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. Multivariate analysis revealed performance status 3-4, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS). Ten patients (18.5%) with stage IV disease were treated with a combination of resection of primary tumour, local treatment of metastasis, and chemotherapy; this group had a median OS of 36.9 months.Conclusions:Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival.
KW - adenocarcinoma
KW - small bowel
KW - small intestine
UR - http://www.scopus.com/inward/record.url?scp=85034865474&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034865474&partnerID=8YFLogxK
U2 - 10.1038/bjc.2017.338
DO - 10.1038/bjc.2017.338
M3 - Article
C2 - 28982111
AN - SCOPUS:85034865474
VL - 117
SP - 1607
EP - 1613
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 11
ER -