A population-based comparison of adenocarcinoma of the large and small intestine: insights into a rare disease.
A population-based comparison of adenocarcinoma of the large and small intestine: insights into a rare disease.
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DOI：
10.1245/s10434-011-2173-6
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发表时间：
2012-05
影响因子：
3.7
通讯作者：
Chang GJ
中科院分区：
文献类型：
--
作者：
Overman MJ;Hu CY;Kopetz S;Abbruzzese JL;Wolff RA;Chang GJ
由于其罕见性，小肠腺癌经常与结肠腺癌进行比较，尽管这种比较的有效性尚不清楚。1988-2007年间诊断的小（SBA）和大肠腺癌（LBA）患者来自SEER登记研究。确定了标准化的发病率和死亡率。计算按分期和评估的淋巴结数量分层的癌症特异性生存期（CSS）。分别确定了4，518例和261，521例SBA和LBA患者。与LBA相比，SBA患者更年轻，分期和组织学分级更高。LBA的年龄标准化发病率下降（-1.24%/年），但SBA增加（+1.47%/年）。虽然LBA和SBA的年龄标准化死亡率都有所下降，但LBA的下降更为明显。与切除的LBA相比，切除的SBA的5年癌症特异性生存率（CSS）更差，尽管当比较评估的淋巴结≥8个的病例时，这种差异减小。当选择≥8个淋巴结时，十二指肠的CSS相对减少要比小肠的空肠/回肠亚部位大得多。在节点选择的情况下，第I、II和III阶段LBA和SBA之间CSS的绝对差异分别为13%、15.9%和18.5%。充分的淋巴结评估在SBA中比LBA少得多，并且似乎SBA，特别是十二指肠腺癌，分期不足。即使在校正以最大限度地减少分期迁移和淋巴结评估不足的影响后，SBA表现出明显差于LBA的CSS。
Because of its rarity, adenocarcinoma of the small intestine is frequently compared to adenocarcinoma of the colon, though the validity of this comparison is not known. Patients with small (SBA) and large bowel adenocarcinoma (LBA) diagnosed between 1988–2007 were identified from the SEER registry. Age-standardized incidence and mortality rates were determined. Cancer-specific survival (CSS) stratified by stage and by number of assessed lymph nodes was calculated. A total of 4,518 and 261,521 patients with SBA and LBA, respectively, were identified. In comparison to LBA, patients with SBA were younger and presented with higher stage and histological grade. The age-standardized incidence rates decreased for LBA (−1.24%/year) but increased for SBA (+1.47%/year). While age-standardized mortality rates decreased for both LBA and SBA, the decreases were more pronounced for LBA. Five-year cancer-specific survival (CSS) was worse for resected SBA compared with resected LBA, though this difference diminished when comparing cases having ≥8 lymph nodes assessed. The relative reduction in CSS when selecting ≥8 lymph nodes was much greater for duodenal as opposed to jejunal/ileal subsite of the small bowel. With nodal selection the absolute difference in CSS between LBA and SBA for stages I, II, and III was 13%, 15.9%, and 18.5%, respectively. Adequate nodal assessment is much less common in SBA than LBA; and it appears that SBA, in particular duodenal adenocarcinoma, is understaged. Even after corrections to minimize the effect of stage migration and inadequate lymph node evaluation, SBA demonstrated distinctly worse CSS than LBA.
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影响因子：
254.7
作者：
Jemal, Ahmedin;Siegel, Rebecca;Thun, Michael J.
通讯作者：
Thun, Michael J.
影响因子：
6.4
作者：
Scélo, G;Boffetta, P;Brennan, P
通讯作者：
Brennan, P
影响因子：
9.7
作者：
LOWENFELS, AB;SONNI, A
通讯作者：
SONNI, A
影响因子：
8
作者：
Bl채ker, H;von Herbay, A;Otto, HF
通讯作者：
Otto, HF
影响因子：
2.3
作者：
ORiordan, BG;Vilor, M;Herrera, L
通讯作者：
Herrera, L