Cao Jun, Zuo Yunxia, Lv Fangfang, Chen Zhiyu, Li Jin
Department of Medical Oncology, Fudan University Cancer Hospital, Shanghai Medical School, Shanghai 200032, P.R. China.
J Clin Gastroenterol. 2008 Feb;42(2):167-73. doi: 10.1097/01.mcg.0000248014.78020.7a.
Primary small intestinal malignant tumor is relatively uncommon compared to gastric and colorectal cancer. It is difficult to make an early diagnosis due to the atypical primary symptoms and lack of effective diagnostic methods.
To analyze the relationship between the prognoses, histologic type, and therapeutic strategy in postoperative patients with small intestinal tumor.
The parameters that affect survival were evaluated using multivariate Cox analysis in 48 cases of small intestinal tumor (confirmed by operation and pathology) for the past 10 years.
The overall survival (OS) of all 48 cases after surgery was 28 months. The 5-year postoperative survival rate for all of the 48 cases was 27.1%. The median OS for all the 20 stage II/III patients who received adjuvant chemotherapy was 28 months, whereas the median OS for the 15 patients who did not receive the therapy was 37 months (P=0.276). The median time to progression for 8 patients with adenocarcinoma who received 5-fluorouracil or platinum-based palliative chemotherapy was 7 months, whereas for the patients who did not receive the therapy it was 3 months (P=0.06). The result of multivariate analyses showed that only the clinical stage was significantly correlated with OS (P<0.001).
The prognosis for small intestinal malignancies is associated with clinical stage, and palliative chemotherapy with a 5-fluorouracil or platinum-based regimen offers a potential benefit to patients with adenocarcinoma. Postoperative adjuvant chemotherapy seems to hold no therapeutic or survival benefit for patients with primary small bowel malignancies.
与胃癌和结直肠癌相比,原发性小肠恶性肿瘤相对少见。由于主要症状不典型且缺乏有效的诊断方法,早期诊断较为困难。
分析小肠肿瘤术后患者的预后、组织学类型和治疗策略之间的关系。
对过去10年中48例小肠肿瘤患者(经手术和病理证实),采用多因素Cox分析评估影响生存的参数。
48例患者术后总生存期(OS)为28个月。48例患者术后5年生存率为27.1%。20例接受辅助化疗的II/III期患者的中位OS为28个月,而15例未接受该治疗的患者的中位OS为37个月(P=0.276)。8例接受5-氟尿嘧啶或铂类姑息化疗的腺癌患者的中位疾病进展时间为7个月,而未接受该治疗的患者为3个月(P=0.06)。多因素分析结果显示,仅临床分期与OS显著相关(P<0.001)。
小肠恶性肿瘤的预后与临床分期有关,5-氟尿嘧啶或铂类方案的姑息化疗对腺癌患者有潜在益处。术后辅助化疗对原发性小肠恶性肿瘤患者似乎没有治疗或生存益处。