Adenocarcinoma of the small bowel

Dabaja, Bouthaina S.; Suki, Dima; Pro, Barbara; Bonnen, Mark; Ajani, Jaffer A.

doi:10.1002/cncr.20404

Cited by 462 publications

(202 citation statements)

References 73 publications

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“…In agreement with previous findings [5,7,13,14,19], we found that relapse occurred at distant sites (100%) but not at locoregional sites (0%). Despite our finding that systemic adjuvant therapy did not enhance RFS or OS, the failure patterns we observed strongly support further investigations of systemic adjuvant therapy.…”

Section: Discussionsupporting

confidence: 82%

“…The factors associated with a poor prognosis in patients with SBA are duodenal location [11,12,13], poor differentiation [11,12], non-curative resection or positive margins [5,7,12,14,15], T 4 tumor stage [5,12], TNM stage [11,13,16], and lymph node involvement [12,14,15,17]. Among our patients, poor differentiation and lymph node involvement were statistically significant indicators of a poor prognosis in univariate analysis, with lymph node involvement being the sole prognostic factor in multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there have been no randomized trials evaluating the role of adjuvant chemotherapy in patients with SBA. Although several retrospective analyses have failed to show benefits from adjuvant chemotherapy, these studies were limited by significant selection bias [5,6,7,8], in that patients selected for adjuvant chemotherapy were at higher risk for relapse and therefore had poorer prognoses than untreated patients.…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Koo¹,

Yun

Hong³

et al. 2011

Oncology

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Objectives: We evaluated prognostic factors affecting relapse-free survival (RFS) and overall survival (OS), and investigated the role of adjuvant chemotherapy in patients with small bowel adenocarcinoma (SBA). Methods: Data from 52 patients with SBA who underwent curative surgery at the Asan Medical Center between January 1989 and December 2009 were retrospectively analyzed. Patients were divided into two groups: those who did (n = 23) and did not (n = 29) receive adjuvant chemotherapy. Results: At a median follow-up of 32.2 months (range, 5.5–212.2 months), relapses had occurred in 17 patients (32.7%), with a 5-year RFS rate of 52.9% (95% CI, 39.3–66.5%), and 19 patients (36.5%) had died, with a 5-year OS rate of 59.0% (95% CI, 45.6–72.4%). The most frequent sites of relapse were the peritoneum and liver. Multivariate analysis showed that lymph node involvement was the only factor independently associated with poor RFS and OS. After inverse probability of treatment weighting adjustment, adjuvant chemotherapy did not enhance RFS [hazard ratio (HR), 1.399; 95% CI, 0.498–3.933] or OS (HR 0.797; 95% CI, 0.307–2.068). Conclusions: Lymph node involvement is a predictor of poor prognosis in patients with SBA who undergo curative surgery.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Koo¹,

Yun

Hong³

et al. 2011

Oncology

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“…Assessment of tumor response (and treatment toxicity) often relied on heterogeneous, obsolete criteria (e.g., clinical examination) [16]. In the most recently published and largest series of 217 patients with SBA (74% with stage III–IV disease) who were registered at the MD Anderson Cancer Center (Houston, Tex., USA) between 1978 and 1998, only 48 (22%) received palliative chemotherapy; however, no details regarding regimens used, efficacy and toxicity were provided [17]. A retrospective series recently reported in abstract form showed that only 14 of the 37 patients with advanced SBA seen in a 10-year period at the BC Cancer Agency received palliative chemotherapy; 19 different palliative-intent regimens, most including a fluoropyrimidine, were used, and resulted in tumor response in 2 patients (response rate 5%): in 1 after infusional 5-FU in the first-line setting, and in 1 after second-line irinotecan [18].…”

Section: Discussionmentioning

confidence: 99%

Combination Chemotherapy in Advanced Small Bowel Adenocarcinoma

Locher¹,

Malka²,

Boige³

et al. 2005

Oncology

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Objective: To assess the efficacy of 5-fluorouracil (5-FU) and either platinum compounds or irinotecan in patients with advanced small bowel adenocarcinoma (SBA), for whom data on the efficacy of chemotherapy are scarce. Methods: We reviewed data on all patients with advanced SBA who received chemotherapy over a 9-year period at our institution. Results: Twenty patients with advanced SBA received a median of 6 cycles (range 2–15) of chemotherapy with 5-FU and either cisplatin (n = 15), carboplatin (n = 2), or oxaliplatin (n = 3). The overall response rate was 21%, and median progression-free and overall survival 8 and 14 months, respectively. Toxicity was moderate. Second-line chemotherapy with 5-FU and irinotecan resulted in disease stabilization in 4 (50%) of 8 patients (median progression-free survival: 5 months), and in a biological complete response in another patient with nonmeasurable peritoneal carcinomatosis, allowing surgical cytoreduction surgery and hyperthermic intraperitoneal chemotherapy. No tumor response or disease stabilization was seen among the patients who received protracted venous infusion of 5-FU (n = 4) or infusional 5-FU and cisplatin (n = 1) as second-line chemotherapy. Conclusion: Chemotherapy with 5-FU and platinum compounds seems effective and well-tolerated in patients with advanced SBA. 5-FU-irinotecan combination chemotherapy deserves further investigation in the first-line setting.

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“…Most studies have concluded that only surgical resection can provide a better prognosis, and that completely or potentially curative resection and positive lymph nodes are of major prognostic significance in SBA. 3,5,6 Therefore, it is important to detect SBA at a stage when curative resec-…”

Section: Introductionmentioning

confidence: 99%

Synchronous Adenocarcinomas of the Ileum and Transverse Colon Detected by Capsule Endoscopy: Report of a Case

et al. 2006

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A 77-year-old woman was admitted to our hospital with anemia and anorexia. Neither gastrointestinal endoscopy nor computed tomography showed by abnormal findings; however, a capsule endoscopy, performed to detect obscure gastrointestinal bleeding, revealed a tumor in the ileum. When we tried to take biopsies of the ileal tumor by push enteroscopy via the anus, we found another tumor in the transverse colon. On exploration, tumors were identified in the ileum and the transverse colon. Thus, we resected the ileum and transverse colon with regional lymph node dissection. Histologic sections from both the ileum and colon revealed moderately differentiated adenocarcinomas with no lymph node metastasis.

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Adenocarcinoma of the small bowel

Cited by 462 publications

References 73 publications

Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Combination Chemotherapy in Advanced Small Bowel Adenocarcinoma

Synchronous Adenocarcinomas of the Ileum and Transverse Colon Detected by Capsule Endoscopy: Report of a Case

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