title: Successful treatment of recurrent small bowel adenocarcinoma by cytoreductive surgery and chemotherapy: a case report and review of the literature.
abstract: BACKGROUND
  Small bowel adenocarcinoma is a rare malignancy associated with a poor prognosis and there is little evidence of effective treatment. Recurrent small bowel adenocarcinoma is an intractable disease for which there is little information available regarding its treatment by palliative therapy. We present a case of recurrent small bowel adenocarcinoma successfully treated by cytoreductive surgery and palliative chemotherapy.
  
  
  METHODS
  We report the case of a 72-year-old Japanese female who developed a peritoneal metastasis from recurrent small bowel adenocarcinoma after curative resection and adjuvant chemotherapy with S-1 and polysaccharide K. She underwent cytoreductive surgery followed by chemotherapy with folinic acid/fluorouracil/oxaliplatin and folinic acid/fluorouracil/irinotecan with polysaccharide K. Subsequently, no sign of a recurrence was observed 42 months after the second operation.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first case report of the successful treatment of peritoneal metastasis from small bowel adenocarcinoma by cytoreductive surgery and combination chemotherapy (folinic acid/fluorouracil/oxaliplatin and folinic acid/fluorouracil/irinotecan with polysaccharide K).
authors.affiliation: Department of Surgery, Kawachi General Hospital, 1-31 Yokomakura, Higashiosaka, Osaka 578-0954, Japan. yamanot@kobe-ekisaikai.or.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yamano
authors.forename: Eiichi
authors.initials: E
authors.lastname: Morii
authors.forename: Isao
authors.initials: I
authors.lastname: Arai
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takada
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Aozasa