Small bowel cancer: single-centre results over a period of 12 years.
OBJECTIVE
Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms. However, diagnosis and treatment are difficult and an ongoing challenge.


METHODS
Follow-up and clinical data of 43 patients with small bowel cancer who underwent surgery at our hospital.


RESULTS
Subgroups consisted of adenocarcinoma (n=16; 37.2%), neuroendocrine tumors (n=12; 27.9%), gastrointestinal stroma tumor (GIST) (n=10; 23.3%), lymphoma (n=3; 7%) and desmoid tumor (n=2; 4.6%). Tumor localizations were within duodenum (46.5%), jejunum (16.3%) and ileum (37.2%). Thirty patients were curatively operated, 13 for palliative treatment or diagnostic purpose. Adenocarcinoma patients showed preponderance of advanced tumor stages: stage I/II in 5 pts, III/IV in 11 patients. Stage distribution for patients with neuroendocrine tumors was 3 each for I and II and 6 for III. Localization was predominantly within the ileum (n=7). Overall survival after five/ten years was 48/37%. Patients with neuroendocrine tumors showed best survival results (75/57%), GIST patients 60/35% and adenocarcinoma (27% each). There was a strong trend towards better survival at early tumor stages in patients with adenocarcinoma and neuroendocrine tumors.


CONCLUSIONS
Early diagnosis is essential for prognosis of small bowel malignancies. Cure is unlikely if lymph node or distant metastases have already developed.
Egberts
Jan-Hendrik
JH
Clinic of General Surgery and Thoracic Surgery, University Hospital of Schleswig-Holstein Campus Kiel, Germany.
Scharrer
Marie-Louise
ML
Hinz
Sebastian
S
Schafmayer
Clemens
C
Klomp
Hans-Juergen
HJ
Faendrich
Fred
F
Tepel
Juergen
J
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000401:mortality; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis / Q000453:epidemiology; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D007580:Jejunal Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging