title: Adjuvant chemotherapy for small bowel adenocarcinoma after curative surgery.
abstract: OBJECTIVE
  We evaluated prognostic factors affecting relapse-free survival (RFS) and overall survival (OS), and investigated the role of adjuvant chemotherapy in patients with small bowel adenocarcinoma (SBA).
  
  
  METHODS
  Data from 52 patients with SBA who underwent curative surgery at the Asan Medical Center between January 1989 and December 2009 were retrospectively analyzed. Patients were divided into two groups: those who did (n = 23) and did not (n = 29) receive adjuvant chemotherapy.
  
  
  RESULTS
  At a median follow-up of 32.2 months (range, 5.5-212.2 months), relapses had occurred in 17 patients (32.7%), with a 5-year RFS rate of 52.9% (95% CI, 39.3-66.5%), and 19 patients (36.5%) had died, with a 5-year OS rate of 59.0% (95% CI, 45.6-72.4%). The most frequent sites of relapse were the peritoneum and liver. Multivariate analysis showed that lymph node involvement was the only factor independently associated with poor RFS and OS. After inverse probability of treatment weighting adjustment, adjuvant chemotherapy did not enhance RFS [hazard ratio (HR), 1.399; 95% CI, 0.498-3.933] or OS (HR 0.797; 95% CI, 0.307-2.068).
  
  
  CONCLUSIONS
  Lymph node involvement is a predictor of poor prognosis in patients with SBA who undergo curative surgery.
authors: Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors: Dong Hoe
authors: DH
authors: Koo
authors: Sung-Cheol
authors: SC
authors: Yun
authors: Yong Sang
authors: YS
authors: Hong
authors: Min-Hee
authors: MH
authors: Ryu
authors: Jae-Lyun
authors: JL
authors: Lee
authors: Heung-Moon
authors: HM
authors: Chang
authors: Yoon-Koo
authors: YK
authors: Kang
authors: Song-Cheol
authors: SC
authors: Kim
authors: Duck-Jong
authors: DJ
authors: Han
authors: Young-Joo
authors: YJ
authors: Lee
authors: Tae Won
authors: TW
authors: Kim
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004379:Duodenal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D007580:Jejunal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis