title: Prognostic clinicopathological factors after curative resection of small bowel adenocarcinoma.
abstract: OBJECTIVE
  Small bowel adenocarcinoma is a relatively uncommon neoplasm that accounts for approximately 0.3% to 2.4% of digestive cancers. In comparison with carcinomas of the other areas of the gastrointestinal tract, the prognosis for small bowel adenocarcinoma is generally worse. The prognostic factors of small bowel adenocarcinoma were analyzed retrospectively, and the significance of operative procedure, lymphadenectomy, and adjuvant chemotherapy was evaluated.
  
  
  METHODS
  From 1990 to 2009, 30 patients with small bowel adenocarcinoma who underwent surgery at Osaka Medical College Hospital were analyzed with respect to tumor extent, operation method, and prognosis.
  
  
  RESULTS
  Overall 5-year survival was 52.5%, and the median survival time was 27.0 months. On univariate and multivariate analyses, the location (duodenum vs. jejunum and ileum), size (greater or less than 70 mm), and tumor, nodes, and metastasis (TNM) stage (stage 0 + I + II vs. III + IV) of the tumor were the significant prognostic factors. No differences in survival and recurrence rates were observed between patients undergoing pancreaticoduodenectomy and those undergoing partial resection, between those undergoing mural lymphadenectomy and those undergoing extended lymphadenectomy, or between those with and without adjuvant chemotherapy. The combination of surgery and adjuvant chemotherapy did not control recurrence or improve the prognosis.
  
  
  CONCLUSIONS
  In small bowel adenocarcinoma, location, size, and TNM stage of the tumors were the independent prognostic factors after curative resections. Partial resection with mural lymphadenectomy may be recommended as optimal surgery for small bowel adenocarcinoma.
authors: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. sur129@poh.osaka-med.ac.jp
authors: Yoshihiro
authors: Y
authors: Inoue
authors: Michihiro
authors: M
authors: Hayashi
authors: Nayuko
authors: N
authors: Satou
authors: Yoshiharu
authors: Y
authors: Miyamoto
authors: Fumitoshi
authors: F
authors: Hirokawa
authors: Mitsuhiro
authors: M
authors: Asakuma
authors: Tetsunosuke
authors: T
authors: Shimizu
authors: Hajime
authors: H
authors: Kayano
authors: Masashi
authors: M
authors: Yamamoto
authors: Hidenori
authors: H
authors: Yamana
authors: Junji
authors: J
authors: Okuda
authors: Yutaro
authors: Y
authors: Egashira
authors: Nobuhiko
authors: N
authors: Tanigawa
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