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The clinical pathological features, diagnosis, treatment and prognosis of small intestine primary malignant tumors

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Abstract

The aim of the study was to describe and analyze the clinicopathological features and diagnosis of Chinese patients with small intestine primary malignant tumors and to explore the best therapy to small bowel adenocarcinoma (SBA). More than 26,000 patients with digestive tract malignant tumors received treatment in PLA hospital from 2000 to 2011, and among them, there were 887 patients who had small intestine primary malignant tumors, and 666 of 887 patients had the completed basic clinical documents. We retrospectively analyzed the correlation between clinical and pathological features of the 666 patients and analyzed the survival and prognosis of 173 SBA patients with follow-up data. Both the number of patients with primary malignant tumors of the small intestine and the number of patients who received chemotherapy showed an increasing trend. The ratio of male to female was 1.58:1. The male patients significantly exceed the female patients with tumors of non-ampullary duodenum, jejunum and duodenal ampulla; and most of the patients are over 60 years of age. For patients burdened with either of the pathological types of tumors, the males exceeded the females, but there was no significant difference. Abdominal pain was the main clinical manifestation for patients with tumors of non-ampullary duodenum, jejunum and ileum, and the most common clinical manifestations were jaundice and abdominal pain for patients with ampullary duodenal tumors, adenocarcinoma, neuroendocrine tumors and sarcoma. In addition, patients with stromal tumors were prone to gastrointestinal bleeding. Gastrointestinal endoscopy was the most common examinational procedure. Patients under 60 years of age were prone to surgery and chemotherapy after surgery, and patients over 60 years of age were prone to supportive treatment and chemotherapy without surgery. The medium overall survival of patients who received surgery without chemotherapy, chemotherapy after surgery, chemotherapy without surgery and supportive treatment were 40.0, 35.0, 9.0 and 7.5 months, respectively. For the 173 SBA patients with follow-up data, treatment, age and distant metastasis were important prognostic factors; 149 of 173 SBA patients received only surgery, and the depth of tumor invasion, lymph node metastasis and surgical approach were important prognostic factors. Adjuvant chemotherapy had not provided significant benefit to prolong OS in patients with adenocarcinoma. The incidence of small intestine primary malignant tumors is very low, and it is difficult to diagnose. The patients should be aggressively treated and regularly followed up with related clinical and pathological features. Currently, surgery is the most effective treatment, and the role of chemotherapy needs further large-scale clinical studies.

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References

  1. Hatzaras I, Palesty JA, Abir F, et al. Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the Connecticut tumor registry. Arch Surg. 2007;142:229–35.

    Article  PubMed  Google Scholar 

  2. Haselkorn T, Whittemore AS, Lilienfeld DE. Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control. 2005;16:781–7.

    Article  PubMed  Google Scholar 

  3. Verma D, Stroehlein JR. Adenocarcinoma of the small bowel: a 60-yr perspective derived from M. D. Anderson Cancer Center Tumor Registry. Am J Gastroenterol. 2006;101(7):1647–54.

    Article  PubMed  Google Scholar 

  4. Dabaja BS, Suki D, Pro B, et al. Adenocarcinoma of the small bowel. Presentation, prognostic factors, and outcome of 217 patients [J]. Cancer. 2004;101(3):518–26.

    Article  PubMed  Google Scholar 

  5. Rondonotti E, Pennazio M, Toth E, et al. Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study. Endoscopy. 2008;40:488–95.

    Article  PubMed  CAS  Google Scholar 

  6. Neugut AI, Marvin MR, Rella VA, et al. An overview of adenocarcinoma of the small intestine. Oncology (Williston Park). 1997;11:529–36 (discussion 545, 549–550).

    CAS  Google Scholar 

  7. O’Riordan BG, Vilor M, Herrera L. Small bowel tumors: an overview. Dig Dis. 1996;14:245–57.

    Article  PubMed  Google Scholar 

  8. Singhal N, Singhal D. Adjuvant chemotherapy for small intestine adenocarcinoma. Cochrane Database Syst Rev. 2007;3:CD005202.

    PubMed  Google Scholar 

  9. Schottenfeld D, Beebe-Dimmer JL, Vigneau FD. The epidemiology and pathogenesis of neoplasia in the small intestine. Ann Epidemiol. 2009;19:58–69.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Haselkorn T, Whittemore AS, Lilienfeld DE. Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control. 2005;16:781–7.

    Article  PubMed  Google Scholar 

  11. Stang A, Stegmaier C, Eisinger B, et al. Descriptive epidemiology of small intestinal malignancies: the German Cancer Registry experience. Br J Cancer. 1999;80:1440–4.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  12. Goodman MT, Matsuno RK, Shvetsov YB. Racial and ethnic variation in the incidence of small-bowel cancer subtypes in the United States, 1995–2008. Dis Colon Rectum. 2013;56:441–8.

    Article  PubMed  Google Scholar 

  13. Han S-L, Cheng J, Zhou H-Z, et al. Surgically treated primary malignant tumor of small bowel: a clinical analysis. World J Gastroenterol. 2010;16(12):1527–32.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Severson RK, Schenk M, Gurney JG, et al. Increasing incidence of adenocarcinomas and carcinoid tumors of the small intestine in adults. Cancer Epidemiol Biomark Prev. 1996;5:81–4.

    CAS  Google Scholar 

  15. Qubaiah O, Devesa SS, Platz CE, et al. Small intestinal cancer: a population-based study of incidence and survival patterns in the United States, 1992 to 2006. Cancer Epidemiol Biomark Prev. 2010;19:1908–18.

    Article  Google Scholar 

  16. Cook MB, Dawsey SM, Freedman ND, et al. Sex disparities in cancer incidence by period and age. Cancer Epidemiol Biomark Prev. 2009;18:1174–82.

    Article  Google Scholar 

  17. Kloppel G, Anlauf M. Epidemiology, tumour biology and histopathological classification of neuroendocrine tumours of the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2005;19(4):507–17.

    Article  PubMed  Google Scholar 

  18. Ross RK, Hartnett NM, Bernstein L, et al. Epidemiology of adenocarcinomas of the small intestine: is bile a small bowel carcinogen? Br J Cancer. 1991;63:143–5.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  19. Lijie YU, Shude LI, Chuangang FU, et al. The analysis of clinical features about 625 cases with small intestine malignant tumors. Tumor. 2012;32(10):811–8.

    Google Scholar 

  20. Alvarado-Cabrero I, Vázquez G, Sierra Santiesteban FI, et al. Clinicopathologic study of 275 cases of gastrointestinal stromal tumors: the experience at 3 large medical centers in Mexico. Ann Diagn Pathol. 2007;11:39–45.

    Article  PubMed  Google Scholar 

  21. Pătraşcu T, Doran H, Strâmbu V, et al. Small bowel tumors. Clinical course and therapeutic aspects. Chirurgia (Bucur). 2006;101:477–81.

    Google Scholar 

  22. Czaykowski P, Hui D. Chemotherapy in small bowel adenocarcinoma: 10-year experience of the British Columbia Cancer Agency. Clin Oncol (R Coll Radiol). 2007;19(2):143–9.

    Article  CAS  Google Scholar 

  23. Overman MJ, Kopetz S, Lin E, et al. Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine [J]. Acta Oncol. 2010;49(4):474–9.

    Article  PubMed  Google Scholar 

  24. Cao J, Zuo Y, Lv F, et al. Primary small intestinal malignant tumors survival analysis of 48 postoperative patients [J]. J Clin Gastroenterol. 2008;42(2):167–73.

    Article  PubMed  Google Scholar 

  25. Halfdanarson TR, Williams RR, Donohue JH, et al. A single-institution experience with 491 cases of small bowel adenocarcinoma [J]. Am J Surg. 2010;199(6):797–803.

    Article  PubMed  Google Scholar 

  26. Overman MJ, Varadhachary GR, Kopetz S, et al. Phase II study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater. J Clin Oncol. 2009;27:2598–603.

    Article  PubMed  CAS  Google Scholar 

  27. Zaanan A, Costes L, Gauthier M, et al. Chemotherapy of advanced small-bowel adenocarcinoma: a multicenter AGEO study. Ann Oncol. 2010;21(9):1786–93.

    Article  PubMed  CAS  Google Scholar 

  28. 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.

    Article  PubMed  Google Scholar 

  29. Delaunoit T, Neczyporenko F, Limburg PJ, et al. Pathogenesis and risk factors of small bowel adenocarcinoma: a colorectal cancer sibling? Am J Gastroenterol. 2005;100:703–10.

    Article  PubMed  Google Scholar 

  30. Ribeiro MB, Greenstein AJ, Heimann TM, et al. Adenocarcinoma of the small intestine in Crohn’s disease. Surg Gynecol Obstet. 1991;173:343–9.

    PubMed  CAS  Google Scholar 

  31. Cooper DL, Doria R, Salloum E. Primary gastrointestinal lymphomas. Gastroenterologist. 1996;4:54–64.

    PubMed  CAS  Google Scholar 

  32. Di Sabatino A, Corazza GR. Coeliac disease. Lancet. 2009;373(9673):1480–93.

    Article  PubMed  Google Scholar 

  33. Neugut AI, Jacobson JS, Suh S, et al. The epidemiology of cancer of the small bowel. Cancer Epidemiol Biomark Prev. 1998;7:243–51.

    CAS  Google Scholar 

  34. Neugut AI, Santos J. The association between cancers of the small and large bowel. Cancer Epidemiol Biomark Prev. 1993;2(6):551–3.

    CAS  Google Scholar 

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None of the authors have any competing financial interest to report.

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Authors and Affiliations

  1. Department of Oncology, PLA General Hospital, Beijing, 100853, People’s Republic of China

    Xiaochuan Guo, Zhiyuan Mao, Dan Su & Li Bai

  2. Department of Ophthalmology, PLA General Hospital, Beijing, 100853, People’s Republic of China

    Zhaocai Jiang

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  1. Xiaochuan Guo
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Correspondence to Li Bai.

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Guo, X., Mao, Z., Su, D. et al. The clinical pathological features, diagnosis, treatment and prognosis of small intestine primary malignant tumors. Med Oncol 31, 913 (2014). https://doi.org/10.1007/s12032-014-0913-8

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