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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
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 Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
노재경(Roh, Jae Kyung)
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
문용화(Moon, Yong Wha)
신상준(Shin, Sang Joon) ORCID logo https://orcid.org/0000-0001-5350-7241
심효섭(Shim, Hyo Sup) ORCID logo https://orcid.org/0000-0002-5718-3624
장현(Chang, Hyun)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101200
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