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

Authors
 Yong Wha Moon  ;  Sun Young Rha  ;  Sang Joon Shin  ;  Hyun Chang  ;  Hyo Sup Shim  ;  Jae Kyung Roh 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.136(3) : 387-394, 2010 
Journal Title
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
ISSN
 0171-5216 
Issue Date
2010
MeSH
Adenocarcinoma/diagnosis* ; Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/therapy* ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Chemotherapy, Adjuvant/methods ; Chemotherapy, Adjuvant/utilization ; Digestive System Surgical Procedures/methods ; Female ; Humans ; Intestinal Neoplasms/diagnosis* ; Intestinal Neoplasms/mortality ; Intestinal Neoplasms/pathology ; Intestinal Neoplasms/therapy* ; Intestine, Small/pathology ; Korea ; Male ; Middle Aged ; Prognosis ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult
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.
Full Text
http://link.springer.com/article/10.1007%2Fs00432-009-0668-3
DOI
10.1007/s00432-009-0668-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Moon, Yong Wha(문용화)
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Chang, Hyun(장현)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101200
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