Characteristics and outcome of patients with small bowel adenocarcinoma (SBA).
Adenocarcinoma
Chemothherapy
Register
Small bowel
Survival
Tumo center
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
11
05
2022
accepted:
31
08
2022
medline:
19
7
2023
pubmed:
28
9
2022
entrez:
27
9
2022
Statut:
ppublish
Résumé
Small bowel adenocarcinoma (SBA) remains a rare malignancy accounting for less than 5% of all the gastrointestinal tract cancers. However, only limited data and expert guidelines are available for this entity. As a result, treatment concepts are predominantly derived from colorectal cancer. To substantiate data on the course of disease, diagnosis and treatment of SBA, we performed a population-based analysis from a Bavarian population of 2.2 million people. We identified 223 patients with SBA. Mean age at diagnosis was 67.8 years and patients were diagnosed rather late (34.5% UICC stage IV). Largest proportion of these patients were diagnosed with adenocarcinoma of the duodenum (132 patients, 59.2%) and most patients were diagnosed with late stage cancer, stage IV (70 patients, 31.4%). With respect to treatment, most patients underwent primary surgery (187 patients, 84.6%). Systemic therapy seemed to have an impact in UICC stage IV patients but not in UICC stage IIB or III. The 5-year survival rate was 29.0%. This was significantly less compared to colon cancer in the same cohort, which was 50.0%. Furthermore, median survival of patients with small bowel cancer was only 2.0 years (95% CI 1.4-2.5) compared to 4.9 years (95% CI 4.8-5.1) of patients with colon cancer. SBA showed a distinct epidemiology compared to colon cancer. Thus, data acquisition particularly on systemic treatment are paramount, with the objective to complement the available guidelines.
Sections du résumé
BACKGROUND
BACKGROUND
Small bowel adenocarcinoma (SBA) remains a rare malignancy accounting for less than 5% of all the gastrointestinal tract cancers. However, only limited data and expert guidelines are available for this entity. As a result, treatment concepts are predominantly derived from colorectal cancer.
METHODS
METHODS
To substantiate data on the course of disease, diagnosis and treatment of SBA, we performed a population-based analysis from a Bavarian population of 2.2 million people.
RESULTS
RESULTS
We identified 223 patients with SBA. Mean age at diagnosis was 67.8 years and patients were diagnosed rather late (34.5% UICC stage IV). Largest proportion of these patients were diagnosed with adenocarcinoma of the duodenum (132 patients, 59.2%) and most patients were diagnosed with late stage cancer, stage IV (70 patients, 31.4%). With respect to treatment, most patients underwent primary surgery (187 patients, 84.6%). Systemic therapy seemed to have an impact in UICC stage IV patients but not in UICC stage IIB or III. The 5-year survival rate was 29.0%. This was significantly less compared to colon cancer in the same cohort, which was 50.0%. Furthermore, median survival of patients with small bowel cancer was only 2.0 years (95% CI 1.4-2.5) compared to 4.9 years (95% CI 4.8-5.1) of patients with colon cancer.
CONCLUSION
CONCLUSIONS
SBA showed a distinct epidemiology compared to colon cancer. Thus, data acquisition particularly on systemic treatment are paramount, with the objective to complement the available guidelines.
Identifiants
pubmed: 36163558
doi: 10.1007/s00432-022-04344-z
pii: 10.1007/s00432-022-04344-z
pmc: PMC10349691
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4579-4590Subventions
Organisme : NIEHS NIH HHS
ID : 27307C0012
Pays : United States
Informations de copyright
© 2022. The Author(s).
Références
Aparicio T, Zaanan A, Svrcek M, Laurent-Puig P, Carrere N, Manfredi S et al (2014) Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment. Dig Liver Dis 46:97–104
doi: 10.1016/j.dld.2013.04.013
pubmed: 23796552
Benson AB, Venook AP, Al-Hawary MM, Arain MA, Chen YJ, Ciombor KK et al (2019) Small bowel adenocarcinoma, version 1.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 17:1109–33
doi: 10.6004/jnccn.2019.0043
pubmed: 31487687
pmcid: 10191182
Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (2004) Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer 101:518–526
doi: 10.1002/cncr.20404
pubmed: 15274064
Di Nardo P, Garattini SK, Torrisi E, Fanotto V, Miolo G, Buonadonna A et al (2022) Systemic treatments for advanced small bowel adenocarcinoma: a systematic review. Cancers (Basel). 14:1502
doi: 10.3390/cancers14061502
pubmed: 35326652
pmcid: 8945891
Farhat MH, Shamseddine AI, Barada KA (2008) Small bowel tumors: clinical presentation, prognosis, and outcome in 33 patients in a tertiary care center. J Oncol 2008:212067
doi: 10.1155/2008/212067
pubmed: 19266087
pmcid: 2648638
Gibson MK, Holcroft CA, Kvols LK, Haller D (2005) Phase II study of 5-fluorouracil, doxorubicin, and mitomycin C for metastatic small bowel adenocarcinoma. Oncologist 10:132–137
doi: 10.1634/theoncologist.10-2-132
pubmed: 15709215
Gustafsson BI, Siddique L, Chan A, Dong M, Drozdov I, Kidd M et al (2008) Uncommon cancers of the small intestine, appendix and colon: an analysis of SEER 1973–2004, and current diagnosis and therapy. Int J Oncol 33:1121–1131
pubmed: 19020744
Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ et al (2007) Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry. Arch Surg 142:229–235
doi: 10.1001/archsurg.142.3.229
pubmed: 17372046
Hirao M, Komori M, Nishida T, Iijima H, Yamaguchi S, Ishihara R et al (2017) Clinical use of molecular targeted agents for primary small bowel adenocarcinoma: a multicenter retrospective cohort study by the Osaka Gut Forum. Oncol Lett 14:1628–1636
doi: 10.3892/ol.2017.6290
pubmed: 28789389
pmcid: 5529922
Horimatsu T, Nakayama N, Moriwaki T, Hirashima Y, Fujita M, Asayama M et al (2017) A phase II study of 5-fluorouracil/L-leucovorin/oxaliplatin (mFOLFOX6) in Japanese patients with metastatic or unresectable small bowel adenocarcinoma. Int J Clin Oncol 22:905–912
doi: 10.1007/s10147-017-1138-6
pubmed: 28536826
pmcid: 5608770
Locher C, Batumona B, Afchain P, Carrere N, Samalin E, Cellier C et al (2018) Small bowel adenocarcinoma: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO). Dig Liver Dis 50:15–19
doi: 10.1016/j.dld.2017.09.123
pubmed: 29174568
Negoi I, Paun S, Hostiuc S, Stoica B, Tanase I, Negoi RI et al (2015) Most small bowel cancers are revealed by a complication. Einstein (Sao Paulo) 13:500–505
doi: 10.1590/S1679-45082015AO3380
pubmed: 26676271
Overman MJ, Varadhachary GR, Kopetz S, Adinin R, Lin E, Morris JS et al (2009) Phase II study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater. J Clin Oncol 27:2598–2603
doi: 10.1200/JCO.2008.19.7145
pubmed: 19164203
Sakae H, Kanzaki H, Nasu J, Akimoto Y, Matsueda K, Yoshioka M et al (2017) The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study. Br J Cancer 117:1607–1613
doi: 10.1038/bjc.2017.338
pubmed: 28982111
pmcid: 5729438
Xiang XJ, Liu YW, Zhang L, Qiu F, Yu F, Zhan ZY et al (2012) A phase II study of modified FOLFOX as first-line chemotherapy in advanced small bowel adenocarcinoma. Anticancer Drugs 23:561–566
doi: 10.1097/CAD.0b013e328350dd0d
pubmed: 22481063