The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study.
The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study.
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DOI：
10.1038/bjc.2017.338
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发表时间：
2017-11-21
影响因子：
8.8
通讯作者：
Okada H
中科院分区：
文献类型：
--
作者：
Sakae H;Kanzaki H;Nasu J;Akimoto Y;Matsueda K;Yoshioka M;Nakagawa M;Hori S;Inoue M;Inaba T;Imagawa A;Takatani M;Takenaka R;Suzuki S;Fujiwara T;Okada H
小肠腺癌（SBA）是一种罕见的恶性肿瘤，占胃肠道肿瘤的1-2%。我们研究了原发性SBA的临床特征、结局和预后因素。我们回顾性分析了2002年6月至2013年8月期间来自日本11家机构的205例SBA患者的特征和临床病程。原发性肿瘤分别位于十二指肠和空肠/回肠149例（72.7%）和56例（27.3%）。64例十二指肠腺癌患者（43.0%）无症状，大多数病例通过食管胃内窥镜检查（EGD）检出，EGD并非专门用于检测或监测十二指肠肿瘤。与此相反，47例（83.9%）空回肠癌有症状。0/I、II、III和IV期癌症的3年生存率分别为93.4%、73.1%、50.9%和15.1%。多变量分析显示体能状态3-4、高癌胚抗原、高乳酸脱氢酶（LDH）、低白蛋白、诊断时有症状和III/IV期疾病是总生存期（OS）的独立因素。10例IV期疾病患者（18.5%）接受了原发性肿瘤切除、转移灶局部治疗和化疗的联合治疗;该组的中位OS为36.9个月。虽然大多数SBA患者被诊断为有症状的晚期疾病，但一些十二指肠癌患者在早期被EGD发现。高LDH和诊断时的症状被确定为OS的新的独立预后因素。晚期SBA的预后差，但结合局部治疗转移的综合治疗可能会延长患者的生存期。
Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1–2% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. We retrospectively analysed the characteristics and clinical courses of 205 SBA patients from 11 institutions in Japan between June 2002 and August 2013. The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. In contrast, 47 patients (83.9%) with jejunoileal carcinoma were symptomatic. The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. Multivariate analysis revealed performance status 3–4, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS). Ten patients (18.5%) with stage IV disease were treated with a combination of resection of primary tumour, local treatment of metastasis, and chemotherapy; this group had a median OS of 36.9 months. Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival.
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影响因子：
168.9
作者：
Cunningham, David;Atkin, Wendy;Starling, Naureen
通讯作者：
Starling, Naureen
影响因子：
9
作者：
Fong, Y;Fortner, J;Blumgart, LH
通讯作者：
Blumgart, LH
影响因子：
3.2
作者：
Chaiyasate, Kongkrit;Jain, Akhilesh K.;Mittal, Vijay K.
通讯作者：
Mittal, Vijay K.
DOI：
10.1016/s0022-5223(99)70106-6
发表时间：
1999-12-01
影响因子：
6
作者：
Kobayashi, K;Kawamura, M;Ishihara, T
通讯作者：
Ishihara, T
影响因子：
6.2
作者：
Dabaja, BS;Suki, D;Ajani, J
通讯作者：
Ajani, J