TY - JOUR
T1 - A single-institution experience with 491 cases of small bowel adenocarcinoma
AU - Halfdanarson, Thorvardur R.
AU - McWilliams, Robert R.
AU - Donohue, John H.
AU - Quevedo, J. Fernando
PY - 2010/6
Y1 - 2010/6
N2 - Background: The optimal treatment of small bowel adenocarcinoma is unknown. Methods: The records of 491 patients with small bowel adenocarcinoma diagnosis between 1970 and 2005 were reviewed for patient and tumor characteristics, treatment effects, and survival. Results: The median age at diagnosis was 62 years. The most common tumor locations were the duodenum (57%), jejunum (29%), and ileum (10%). The median overall survival was 20.1 months, with a 5-year overall survival of 26%. Greater age, male sex, higher stage and grade, residual disease after resection, and a lymph node ratio of 50% or greater predicted decreased overall survival in univariate analysis. Age and stage were predictive of survival in multivariate analysis. The overall survival with metastatic disease was poor. Adjuvant therapy was not associated with longer overall survival (P = .44). Conclusions: The prognosis of patients with small bowel adenocarcinoma is poor. Complete resection provides the only means of cure, and the role for adjuvant therapy remains uncertain.
AB - Background: The optimal treatment of small bowel adenocarcinoma is unknown. Methods: The records of 491 patients with small bowel adenocarcinoma diagnosis between 1970 and 2005 were reviewed for patient and tumor characteristics, treatment effects, and survival. Results: The median age at diagnosis was 62 years. The most common tumor locations were the duodenum (57%), jejunum (29%), and ileum (10%). The median overall survival was 20.1 months, with a 5-year overall survival of 26%. Greater age, male sex, higher stage and grade, residual disease after resection, and a lymph node ratio of 50% or greater predicted decreased overall survival in univariate analysis. Age and stage were predictive of survival in multivariate analysis. The overall survival with metastatic disease was poor. Adjuvant therapy was not associated with longer overall survival (P = .44). Conclusions: The prognosis of patients with small bowel adenocarcinoma is poor. Complete resection provides the only means of cure, and the role for adjuvant therapy remains uncertain.
KW - Abdominal neoplasms
KW - Adenocarcinoma
KW - Duodenum
KW - Ileum
KW - Jejunum
UR - http://www.scopus.com/inward/record.url?scp=77953666440&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953666440&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2009.05.037
DO - 10.1016/j.amjsurg.2009.05.037
M3 - Article
C2 - 20609724
AN - SCOPUS:77953666440
SN - 0002-9610
VL - 199
SP - 797
EP - 803
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -