Chaiyasate Kongkrit, Jain Akhilesh K, Cheung Laurence Y, Jacobs Michael J, Mittal Vijay K
Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA.
World J Surg Oncol. 2008 Jan 31;6:12. doi: 10.1186/1477-7819-6-12.
Adenocarcinoma of the small bowel is a relatively rare malignancy as compared to the other malignancies of the gastrointestinal tract. Nonspecific presentation and infrequent occurrence often leads to a delay in diagnosis and consequent poor prognosis. Various other factors are of prognostic importance while managing these tumors.
The medical records of a total of 27 patients treated for adenocarcinoma of the small bowel at Providence Hospital and Medical Centers from year 1990 through 2003 were reviewed retrospectively. Data were analyzed using SPSS software (version 10.0; SPSS, Inc., Chicago, IL). Survival analyses were calculated using the Kaplan Meier method with the log rank test to assess the statistical significance. The socio-demographics (age, gender) were calculated using frequency analyses.
The patients included nine males and eighteen females with a median age at diagnosis of 62 years. Only 48% of the patients had an accurate preoperative diagnosis while another 33% had a diagnosis suspicious of small bowel malignancy. None of the patients presented in stage 1. The cumulative five-year survival was 30% while the median survival was 3.3 years. There was no 30-day mortality in the postoperative period in our series.
The univariate analysis demonstrated that tumor grade, stage at presentation, lymph nodal metastasis and resection margins were significant predictors of survival.
与胃肠道的其他恶性肿瘤相比,小肠腺癌是一种相对罕见的恶性肿瘤。非特异性表现和发病率低常常导致诊断延迟,进而预后不良。在处理这些肿瘤时,其他各种因素对预后也很重要。
回顾性分析了1990年至2003年在普罗维登斯医院及医疗中心接受小肠腺癌治疗的27例患者的病历。使用SPSS软件(版本10.0;SPSS公司,伊利诺伊州芝加哥)进行数据分析。采用Kaplan-Meier方法和对数秩检验计算生存分析,以评估统计学意义。使用频率分析计算社会人口统计学特征(年龄、性别)。
患者包括9名男性和18名女性,诊断时的中位年龄为62岁。只有48%的患者术前诊断准确,另有33%的患者诊断怀疑为小肠恶性肿瘤。没有患者处于1期。累积五年生存率为30%,中位生存期为3.3年。在我们的系列研究中,术后30天内无死亡病例。
单因素分析表明,肿瘤分级、就诊时分期、淋巴结转移和切缘是生存的重要预测因素。