Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study-Reference-Cited by-同舟云学术

Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study

Published:2024-02 Issue:10 Volume: Page:
ISSN:2687-8941
Container-title:JCO Global Oncology
language:en
Short-container-title:JCO Glob Oncol

Author:

Nishikawa Yoshitaka¹²^ORCID,Horimatsu Takahiro¹,Oka Shiro³^ORCID,Yamada Takeshi⁴^ORCID,Mitsui Keigo⁵^ORCID,Yamamoto Hironori⁶^ORCID,Takahashi Keiichi⁷,Shiomi Akio⁸^ORCID,Hotta Kinichi⁹^ORCID,Takeuchi Yoji¹⁰^ORCID,Kuwai Toshio¹¹^ORCID,Ishida Fumio¹²,Kudo Shin-Ei¹²,Saito Shoichi¹³,Ueno Masashi¹⁴,Sunami Eiji¹⁵,Yamano Tomoki¹⁶^ORCID,Itabashi Michio¹⁷,Ohtsuka Kazuo¹⁸,Kinugasa Yusuke¹⁹^ORCID,Matsumoto Takayuki²⁰,Sugai Tamotsu²¹^ORCID,Uraoka Toshio²²^ORCID,Kurahara Koichi²³,Yamaguchi Shigeki²⁴^ORCID,Kato Tomohiro²⁵,Okajima Masazumi²⁶,Kashida Hiroshi²⁷^ORCID,Fujita Fumihiko²⁸^ORCID,Ikematsu Hiroaki²⁹^ORCID,Ito Masaaki³⁰^ORCID,Esaki Motohiro³¹,Kawai Masaya³²^ORCID,Yao Takashi³³^ORCID,Hamada Madoka³⁴^ORCID,Koda Keiji³⁵^ORCID,Fukai Yasumori³⁶,Komori Koji³⁷^ORCID,Saitoh Yusuke³⁸,Kanemitsu Yukihide³⁹^ORCID,Takamaru Hiroyuki⁴⁰^ORCID,Yamada Kazutaka⁴¹,Nozawa Hiroaki⁴²,Takayama Tetsuji⁴³^ORCID,Togashi Kazutomo⁴⁴,Shinto Eiji⁴⁵^ORCID,Torisu Takehiro⁴⁶,Toyoshima Akira⁴⁷,Ohmiya Naoki⁴⁸,Kato Takeshi⁴⁹^ORCID,Otsuji Eigo⁵⁰,Nagata Shinji⁵¹,Hashiguchi Yojiro⁵²^ORCID,Sugihara Kenichi⁵³,Ajioka Yoichi⁵⁴,Tanaka Shinji⁵⁵^ORCID

Affiliation:

1. Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan

2. Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan

3. Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan

4. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan

5. Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan

6. Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan

7. Department of Colorectal Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

8. Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan

9. Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan

10. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan

11. Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan

12. Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan

13. Department of Lower Gastrointestinal Medicine, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

14. Department of Gastroenterological and Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

15. Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan

16. Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

17. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

18. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan

19. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan

20. Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan

21. Department of Diagnostic Pathology, Iwate Medical University, Iwate, Japan

22. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan

23. Division of Gastroenterology, Matsuyama Red Cross Hospital, Ehime, Japan

24. Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan

25. Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

26. Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

27. Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan

28. Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan

29. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan

30. Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan

31. Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan

32. Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan

33. Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan

34. Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Osaka, Japan

35. Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan

36. Department of Gastroenterology, Maebashi Red Cross Hospital, Gunma, Japan

37. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan

38. Department of Gastroenterology, Asahikawa City Hospital, Asahikawa, Japan

39. Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan

40. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

41. Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan

42. Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan

43. Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

44. Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan

45. Department of Surgery, National Defense Medical College, Tokorozawa, Japan

46. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

47. Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan

48. Department of Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan

49. Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan

50. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

51. Department of Gastroenterology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan

52. Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan

53. Tokyo Medical and Dental University, Tokyo, Japan

54. Division of Molecular and Diagnostic Pathology Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

55. JA Onomichi General Hospital, Hiroshima, Japan

Abstract

PURPOSE Limited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA. METHODS This retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests. RESULTS Data from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively. CONCLUSION Patients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.

Publisher

American Society of Clinical Oncology (ASCO)

Link

https://ascopubs.org/doi/pdfdirect/10.1200/GO.23.00392

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