Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Koo, Dong Hoe; Yun, Sangwon; Hong, Yong Sang; Ryu, Min‐Hee; Lee, Jae‐Lyun; Chang, Heung-Moon; Kang, Yoon‐Koo; Kim, Song Cheol; Han, Duck‐Jong; Lee, Young‐Joo; Kim, Tae Won

doi:10.1159/000328506

Cited by 21 publications

(25 citation statements)

References 37 publications

(21 reference statements)

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“…69 Adjuvant chemotherapy in another study of 52 small bowel cancers similarly did not seem to improve recurrence free survival. 70 A successful case of partial response with capecitabine and oxaliplatin has been described after the development of recurrence and peritoneal disease after pancreaticoduodenectomy for duodenal cancer. 71 In another case report, FOLFOX achieved a partial response in recurrent disease after a pancreaticoduodenectomy for duodenal cancer.…”

Section: Chemotherapy In Duodenal Cancermentioning

confidence: 99%

Advances in Molecular Pathology and Treatment of Periampullary Cancers

Chandrasegaram¹,

Chen

Price

et al. 2016

Pancreas

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Section: Chemotherapy In Duodenal Cancermentioning

confidence: 99%

Advances in Molecular Pathology and Treatment of Periampullary Cancers

Chandrasegaram¹,

Chen

Price

et al. 2016

Pancreas

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“…In addition, poorly differentiated adenocarcinoma, as in the current case, is one of the predictors of poor outcome (8). There have been only a limited number of studies on the subject of adjuvant chemotherapy for SBAs, most of which are retrospective (16,17). Similarly, the majority of published studies pertaining to palliative chemotherapy for advanced SBAs are retrospective and limited in number.…”

Section: Discussionmentioning

confidence: 99%

Small bowel adenocarcinoma arising in a patient with hereditary hemorrhagic telangiectasia: A case report

et al. 2016

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Abstract. Patients with hereditary hemorrhagic telangiectasia (HHT) are reportedly at a lower overall risk of malignancies, and small bowel adenocarcinoma (SBA) arising in a HHT patient is extremely rare. In this study, the case of a 37-year-old female with HHT who developed a poorly differentiated jejunal adenocarcinoma five years after ileocecal resection for multiple colonic adenomas is presented. The patient underwent curative resection of the cancer invading the ileum and the mesentery of the transverse colon, but had to overcome critical complications perioperatively, stemming from HHT-associated peripheral capillary dilatation and arteriovenous malformation, including nosebleeds and possible infusion-induced air embolism through pulmonary shunts. The patient subsequently received adjuvant chemotherapy including capecitabine and oxaliplatin for 6 months, and currently remains alive without any evidence of recurrence 12 months after the second surgery. This patient with SBA was an instructive case demonstrating the necessity of careful attention during major surgery in HHT. IntroductionHereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease, is an autosomal dominant disorder characterized by cutaneous and/or mucosal telangiectasias and arteriovenous malformations (AVMs), with a prevalence rate of 1-2 patients per 10,000 individuals worldwide (1). HHT is clinically diagnosed using the Curaçao criteria, which was established in 1999 (2). Approximately 80% of HHT patients exhibit a mutation in endoglin or activin A receptor-like kinase 1 genes. Repeated nosebleeds due to the mucosal telangiectasias are the most common somatic symptom and present a major HHT-related health concern that affects patient quality of life (3). At present, an optimal treatment strategy for HHT has not yet been established. However, in patients that exhibit severe bleeding, infection and hypoxia, surgery is usually required (3,4). The prognosis of HHT patients depends on the presence of the infection associated with AVMs, including organ abscesses and sepsis (1). Notably, the mean lifespan of HHT patients has been found to be shortened when compared with controls (63.2 vs. 70.0 years) (4). To date, only a few cases of tumors arising in the small bowel have been reported (5,6). In this study, the first case of a patient with HHT to develop cancer of the jejunum following surgical removal of multiple colonic adenomas is presented. Case reportA 32-year-old female underwent a laparoscopy-assisted ileocecal resection for multiple polyps in the cecum and appendix veriforme at the University of Tokyo Hospital, (Tokyo, Japan), as reported in a previous study (7). The patient was subsequently diagnosed with HHT. Five years later, she visited a local practitioner complaining of appetite loss which had lasted for two months, recent abdominal pain, and intermittent vomiting. Shortly thereafter, the patient was referred back to the University of Tokyo Hospital to receive treatment for obstructive ileus, which was manag...

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“…The number of studies on adjuvant chemotherapy for small bowel cancer is limited and the effects of chemotherapy on the prevention of recurrence and prolongation of survival remain to be verified in small bowel cancer patients (13,14). Our study results did not confirm the efficacy of postoperative adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

The effects of chemotherapy on primary small bowel cancer: A retrospective multicenter observational study in Japan

Mizushima

Mishima

Ikeda

et al. 2013

Molecular and Clinical Oncology

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Small bowel cancer is relatively rare among gastrointestinal tract cancers, including esophageal, gastric and colorectal cancers. The majority of cases of small bowel cancer are diagnosed at an advanced stage, resulting in poor outcomes. The clinical effects of chemotherapy on small bowel cancer have been investigated in a limited number of studies from Europe and the USA. However, they have not yet been fully investigated in Asian countries, including Japan. This retrospective multicenter observational study was designed to investigate the efficacy of chemotherapy on small bowel cancer. A questionnaire survey was conducted in 28 hospitals affiliated with the Osaka University Hospital. We retrospectively reviewed the medical records of 61 patients with small bowel cancer (32 patients who were unable to undergo curative resection or had unresectable distant metastases and 29 who underwent curative resection), treated between 1996 and 2009, to evaluate the outcomes and the efficacy of chemotherapy. There was no significant difference in the overall survival between the patients undergoing curative resection with postoperative adjuvant chemotherapy and those without postoperative adjuvant chemotherapy. In patients with non-curative resection or unresectable distant metastases, the response rate to chemotherapy was 31.6% and the overall survival was significantly higher compared to that without chemotherapy (P=0.008). The study results suggested that chemotherapy is effective for Japanese patients with small bowel cancer who cannot undergo curative resection or have unresectable distant metastases.

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Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery

Cited by 21 publications

References 37 publications

Advances in Molecular Pathology and Treatment of Periampullary Cancers

Advances in Molecular Pathology and Treatment of Periampullary Cancers

Small bowel adenocarcinoma arising in a patient with hereditary hemorrhagic telangiectasia: A case report

The effects of chemotherapy on primary small bowel cancer: A retrospective multicenter observational study in Japan

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