Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan
-
Published:2024-02-27
Issue:5
Volume:59
Page:376-388
-
ISSN:0944-1174
-
Container-title:Journal of Gastroenterology
-
language:en
-
Short-container-title:J Gastroenterol
Author:
Yamashita Ken, Oka ShiroORCID, Yamada Takeshi, Mitsui Keigo, Yamamoto Hironori, Takahashi Keiichi, Shiomi Akio, Hotta Kinichi, Takeuchi Yoji, Kuwai Toshio, Ishida Fumio, Kudo Shin-Ei, Saito Shoichi, Ueno Masashi, Sunami Eiji, Yamano Tomoki, Itabashi Michio, Ohtsuka Kazuo, Kinugasa Yusuke, Matsumoto Takayuki, Sugai Tamotsu, Uraoka Toshio, Kurahara Koichi, Yamaguchi Shigeki, Kato Tomohiro, Okajima Masazumi, Kashida Hiroshi, Akagi Yoshito, Ikematsu Hiroaki, Ito Masaaki, Esaki Motohiro, Kawai Masaya, Yao Takashi, Hamada Madoka, Horimatsu Takahiro, Koda Keiji, Fukai Yasumori, Komori Koji, Saitoh Yusuke, Kanemitsu Yukihide, Takamaru Hiroyuki, Yamada Kazutaka, Nozawa Hiroaki, Takayama Tetsuji, Togashi Kazutomo, Shinto Eiji, Torisu Takehiro, Toyoshima Akira, Ohmiya Naoki, Kato Takeshi, Otsuji Eigo, Nagata Shinji, Hashiguchi Yojiro, Sugihara Kenichi, Ajioka Yoichi, Tanaka Shinji
Abstract
Abstract
Background
The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.
Methods
We analyzed 354 patients with 358 PSBAs, between January 2008 and December 2017, at 44 institutions affiliated with the Japanese Society for Cancer of the Colon and Rectum.
Results
The median age was 67 years (218 males, 61.6%). The average tumor size was 49.9 (7–100) mm. PSBA sites consisted of jejunum (66.2%) and ileum (30.4%). A total of 219 patients (61.9%) underwent diagnostic small bowel endoscopy, including single-balloon endoscopy, double-balloon endoscopy, and capsule endoscopy before treatment. Nineteen patients (5.4%) had Lynch syndrome, and 272 patients (76.8%) had symptoms at the initial diagnosis. The rates for stages 0, I, II, III, and IV were 5.4%, 2.5%, 27.1%, 26.0%, and 35.6%, respectively. The 5-year overall survival rates at each stage were 92.3%, 60.0%, 75.9%, 61.4%, and 25.5%, respectively, and the 5-year disease-specific survival (DSS) rates were 100%, 75.0%, 84.1%, 59.3%, and 25.6%, respectively. Patients with the PSBA located in the jejunum, with symptoms at the initial diagnosis or advanced clinical stage had a worse prognosis. However, multivariate analysis using Cox-hazard model revealed that clinical stage was the only significant predictor of DSS for patients with PSBA.
Conclusions
Of the patients with PSBA, 76.8% had symptoms at the initial diagnosis, which were often detected at an advanced stage. Detection during the early stages of PSBA is important to ensure a good prognosis.
Funder
Hiroshima University
Publisher
Springer Science and Business Media LLC
Reference34 articles.
1. Bilimoria KY, Bentrem DJ, Wayne JD, et al. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg. 2009;249:63–71. 2. Wilhelm A, Galata C, Beutner U, et al. Duodenal localization is a negative predictor of survival after small bowel adenocarcinoma resection: a population-based, propensity score-matched analysis. J Surg Oncol. 2018;117:397–408. 3. Overman MJ, Hu C-Y, Kopetz S, et al. A population-based comparison of adenocarcinoma of the large and small intestine: insights into a rare disease. Ann Surg Oncol. 2012;19:1439–45. 4. Legué LM, Bernards N, Gerritse SL, et al. Trends in incidence, treatment and survival of small bowel adenocarcinomas between 1999 and 2013: a population-based study in the Netherlands. Acta Oncol. 2016;55:1183–9. 5. Schottenfeld D, Beebe-Dimmer JL, Vigneau FD. The epidemiology and pathogenesis of neoplasia in the small intestine. Ann Epidemiol. 2009;19:58–69.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|