Evaluation of Prognostic Factors and Adjuvant Chemotherapy in Patients With Small Bowel Adenocarcinoma Who Underwent Curative Resection.
Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Because these are rarely encountered tumors, the aim of this multicenter study was evaluation of prognostic factors and adjuvant chemotherapy in patients with curatively resected SBA.



A total of 78 patients diagnosed with curatively resected SBA were involved in the retrospective study. Forty-eight patients received 1 of 3 different chemotherapy regimens, whereas 30 patients did not receive any adjuvant treatment. No adjuvant and adjuvant chemotherapy cohorts were matched (1:1) by propensity scores based on the likelihood of receiving chemotherapy or the survival hazard from Cox modeling. Overall survival (OS) was compared with Kaplan-Meier estimates.



Median age of 78 patients with curatively resected SBA was 58, and 59% of these were men. According to TNM classification, 8 (10%) of the patients were at stage I, 26 (34%) were at stage II, and 44 (56%) were at stage III. Median follow-up duration was 29 months. Three-year median disease-free survival (DFS) and OS were 62.5% and 67.0%, respectively. In univariate analysis, presence of vascular invasion, perineural invasion, lymph node involvement, and presence of positive surgical margin were significant predictors of poor survival. Multivariate analysis showed that the only adverse prognostic factor independently related with OS was the presence of positive surgical margin (hazard ratio, 0.37; 95% confidence interval, 0.11-1.26; P = .01). Neither DFS nor OS was found to be significantly improved by the adjuvant chemotherapy in both matched and unmatched cohorts.



Only status of surgical margin was determined to be an independent prognostic factor in patients with SBA who underwent curative resection.
Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. Electronic address: dinceraydin79@yahoo.com.
Dincer
D
Aydin
Department of Medical Oncology, Numune Education and Research Hospital, Ankara, Turkey.
Mehmet Ali
MA
Sendur
Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Umut
U
Kefeli
Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Olcun Umit
OU
Unal
Department of Medical Oncology, Faculty of Medicine, Selcuk University Meram, Konya, Turkey.
Didem
D
Tastekin
Department of Medical Oncology, Faculty of Medicine, Katip Celebi University, Izmir, Turkey.
Murat
M
Akyol
Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey.
Eda
E
Tanrikulu
Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Aydin
A
Ciltas
Department of Medical Oncology, Haydarpasa Education and Research Hospital, Istanbul, Turkey.
Basak Bala
BB
Ustaalioglu
Department of Medical Oncology, Faculty of Medicine, Kocatepe University, Afyon, Turkey.
Mukremin
M
Uysal
Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
Onur
O
Esbag
Department of Medical Oncology, Konya Education and Research Hospital, Konya, Turkey.
Dogan
D
Yazilitas
Department of Medical Oncology, Faculty of Medicine, Muğla University, Muğla, Turkey.
Ozgur
O
Tanrıverdi
Department of Medical Oncology, Faculty of Medicine, Medipol University, İstanbul, Turkey.
Ahmet
A
Bilici
Department of Medical Oncology, Sakarya Education and Research Hospital, Sakarya, Turkey.
Erkan
E
Arpaci
Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Veli
V
Berk
Department of Medical Oncology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.
Tarkan
T
Yetisyigit
Department of Medical Oncology, Numune Education and Research Hospital, Ankara, Turkey.
Nuriye Yildirim
NY
Ozdemir
Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Ilhan
I
Oztop
Department of Medical Oncology, Faculty of Medicine, Katip Celebi University, Izmir, Turkey.
Ahmet
A
Alacacioglu
Department of Medical Oncology, Haydarpasa Education and Research Hospital, Istanbul, Turkey.
Ozhan
O
Aydin
Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Melike
M
Ozcelik
Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Emre
E
Yildirim
Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Nur
N
Dinc
Department of Medical Oncology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey.
Mahmut
M
Gumus
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D013505:Digestive System Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D007421:Intestine, Small / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
Adenocarcinoma; Adjuvant; Chemotherapy; Prognosis; Small bowel