title: Characteristics and Treatment Strategies for Small Bowel Adenocarcinoma in Advanced-stage Cases.
abstract: BACKGROUND
  Small bowel adenocarcinoma is an uncommon disease with poor prognosis. Therefore, characteristics and treatment strategies for small bowel adenocarcinoma should be elucidated sufficiently, not only for surgery, but also for chemotherapy.
  
  
  METHODS
  Medical records were abstracted to identify patients with small bowel adenocarcinoma who were treated at the Iizuka Hospital, Fukuoka, Japan, between 2004 and 2014. The results of surgical treatment for stage II/III cases and the efficacy of chemotherapy for unresectable stage IV cases were investigated.
  
  
  RESULTS
  The median tumor size was 25.6 ± 19.2 mm, and tumor size was not associated with primary symptoms. Nine of the patients were diagnosed with stage II/III disease and underwent surgical resection. The other three patients were diagnosed with stage IV disease, and two out of those three cases received definitive chemotherapy. In two out of the nine resected cases, recurrence was observed; however, surgical resection of the recurrent tumor was associated with a good prognosis. In stage IV cases that received chemotherapy, survival durations of over 11 months were achieved. In contrast, overall survival in the stage IV case without chemotherapy was 3.3 months.
  
  
  CONCLUSIONS
  Curative resection and definitive chemotherapy for unresectable cases are effective treatment strategies for small bowel adenocarcinoma.
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakanoko
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Koga
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Taketani
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Hirayama
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Yoshiya
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Minagawa
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kai
authors.affiliation: Iizuka Hospital, Fukuoka, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kajiyama
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan maehara@surg2.med.kyushu-u.ac.jp.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D016896:Treatment Outcome
keywords: curative surgery; definitive chemotherapy; distant metastasis; recurrent tumor resection; small bowel adenocarcinoma; unresectable case