Adenocarcinoma of the Small Bowel

• DOI: 10.1007/s10350-004-6457-9
• Publication Date: 2004-12-16T05:07:46Z
• Authors: Neil A. Abrahams; Amy Halverson; Victor W. Fazio; Lisa A. Rybicki; John R. Goldblum
• Keywords: Surgical oncology

PURPOSE: Primary small-bowel adenocarcinoma is uncommon. There are few large studies that have evaluated the prognostic impact of clinical and pathologic parameters. The purpose this study was to perform a comprehensive analysis Cleveland Clinic experience with adenocarcinoma, emphasis on histopathologic parameters as indicators. METHODS: Thirty-seven cases primary adenocarcinomas resected at between 1978 1999 were retrospectively studied. Metastatic tumors those arising from biliary system excluded analysis. Clinical data recorded their prognosis by either Kaplan-Meier or Cox proportional hazards RESULTS: cohort included 25 males, age range 24 82 (mean, 56) years. Tumor location duodenum (18), jejunum (10), ileum (2), site not specified (7). Patients most frequently presented abdominal pain (48 percent), anemia (39 percent) obstruction (33 percent). Underlying conditions Crohn's disease (4) familial adenomatous polyposis (2). Overall survival 52 47 percent 5 10 years, respectively, mean follow-up 50.5 (range, 0.5-184) months for all patients. Features found be negative factors positive surgical margins (P< 0.001), extramural venous spread lymph node metastases (P= 0.038), poor tumor differentiation 0.015), depth invasion 0.023), history 0.001). Age, gender, size, growth pattern, lymphocytic host response, adjuvant therapy did affect survival. CONCLUSIONS: Pathologic features, including margins, spread, nodes, differentiation, invasion, disease, major significance in adenocarcinoma. Although many these features similar ones used colorectal they easily applicable reproducible adenocarcinomas. This important considering often dismal