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. 2010 Mar;136(3):387-94.
doi: 10.1007/s00432-009-0668-3. Epub 2009 Sep 16.

Adenocarcinoma of the small bowel at a single Korean institute: management and prognosticators

Yong Wha Moon  1 , Sun Young Rha, Sang Joon Shin, Hyun Chang, Hyo Sup Shim, Jae Kyung Roh
Affiliations

Adenocarcinoma of the small bowel at a single Korean institute: management and prognosticators

Yong Wha Moon et al. J Cancer Res Clin Oncol. 2010 Mar.

Abstract

Purpose: Small bowel adenocarcinoma (SBA) is a rare malignancy with a poor outcome. We evaluated the natural history of SBA at a single Korean institute.

Methods: Medical records of 100 patients with SBA were reviewed for clinical characteristics, treatment patterns, outcomes, and prognostic factors.

Results: The most common primary tumor site was the duodenum (82%). Seventy-four patients were diagnosed with stage III/IV disease (28/46 patients, respectively). Sixty-six patients had surgery (R0/R1/R2 in 32/2/32) without operation-related mortality. Of 34 R0/R1-resected patients, 16 received adjuvant chemotherapy. The dominant pattern of recurrence following R0/R1 resection was distant metastasis (29%; 10 of 34 patients). Thirty-four patients with advanced SBA received palliative chemotherapy, showing a response rate of 27.6% and a median progression-free survival of 3.8 months. The median overall survival for all patients and R0/R1-resected patients was 10.5 and 42.1 months, respectively. In multivariate analysis, lower stage, nonduodenal location, and R0/R1 resection were good independent prognostic factors.

Conclusions: Early diagnosis is crucial to improve outcomes of SBA with respect to increasing resectability. Distant metastasis as a dominant pattern of recurrence suggests a potential role for adjuvant chemotherapy. Newer antitumor agents in advanced SBA should be evaluated considering the poor efficacy of current palliative chemotherapy.

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Figures

Fig. 1
Fig. 1
Treatment modalities. CTx chemotherapy, Tx treatment. R0/1/2 indicates R0/1/2 resections. Of 34 R0/1 resected patients, 2 received R1 resection
Fig. 2
Fig. 2
a Overall survival (OS) of all patients, according to the b treatment modalities, c stages, and d years of diagnosis. CI confidence interval, m month, 5Y 5 year
Fig. 3
Fig. 3
a Overall survival according to type of surgery and b palliative chemotherapy. CTx chemotherapy. Candidates of palliative chemotherapy included unresected, R2 resected or recurred patients (n = 87)
See this image and copyright information in PMC

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