Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Oncology. 2011;80(3-4):208-13. doi: 10.1159/000328506. Epub 2011 Jul 1.
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).
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.
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).
Lymph node involvement is a predictor of poor prognosis in patients with SBA who undergo curative surgery.
我们评估了影响无复发生存（RFS）和总生存（OS）的预后因素，并探讨了辅助化疗在小肠腺癌（SBA）患者中的作用。
回顾性分析了 1989 年 1 月至 2009 年 12 月期间在 Asan 医疗中心接受根治性手术的 52 例 SBA 患者的数据。患者分为两组：接受（n=23）和未接受（n=29）辅助化疗。
中位随访 32.2 个月（范围，5.5-212.2 个月）后，17 例患者（32.7%）出现复发，5 年 RFS 率为 52.9%（95%CI，39.3-66.5%），19 例患者（36.5%）死亡，5 年 OS 率为 59.0%（95%CI，45.6-72.4%）。复发最常见的部位是腹膜和肝脏。多因素分析显示，淋巴结受累是与 RFS 和 OS 不良相关的唯一因素。经过逆概率治疗加权调整后，辅助化疗并未提高 RFS[风险比（HR），1.399；95%CI，0.498-3.933]或 OS（HR 0.797；95%CI，0.307-2.068）。
淋巴结受累是接受根治性手术的 SBA 患者预后不良的预测因素。
