Falcone Rosa, Romiti Adriana, Filetti Marco, Roberto Michela, Righini Riccardo, Botticelli Andrea, Pilozzi Emanuela, Ghidini Michele, Pizzo Claudio, Mazzuca Federica, Marchetti Paolo
Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
Ospedale Israelitico, Rome, Italy.
Tumori. 2019 Dec;105(6):524-528. doi: 10.1177/0300891619839297. Epub 2019 Apr 1.
Because of a lack of large-scale prospective studies there is no clear indication about the management of patients with small bowel adenocarcinoma (SBA). This study evaluated clinical outcome of patients diagnosed with SBA at our institution.
Clinicopathologic features, treatments, and clinical outcome of patients diagnosed with SBA between 2006 and 2017 were retrospectively analyzed. Median time of survival was calculated and compared using the log-rank test. Multivariate Cox regression was used to test independence of significant factors in univariate analysis.
Forty patients were included in the study; the majority (82.5%) had a tumor in the duodenum (including ampulla of Vater) and an early stage disease at the diagnosis. Median overall survival (OS) in the whole study population was 26.5 months. Patients with a tumor of the lower part of the small intestine (jejunum, ileum, and appendix) showed a better OS compared with that of patients with upper SBA (40 months vs 26 months, respectively; =0.09). Primary tumor site and stage were independent predictors of OS.
Our results suggest a prognostic role for the primary tumor site. This finding deserves to be further investigated to ensure better classification as well as more effective management strategies for SBA.
由于缺乏大规模前瞻性研究，对于小肠腺癌（SBA）患者的管理尚无明确指征。本研究评估了在我们机构诊断为SBA的患者的临床结局。
回顾性分析2006年至2017年间诊断为SBA的患者的临床病理特征、治疗方法和临床结局。使用对数秩检验计算并比较中位生存时间。多因素Cox回归用于检验单因素分析中显著因素的独立性。
40例患者纳入本研究；大多数（82.5%）在十二指肠（包括Vater壶腹）有肿瘤，且诊断时处于疾病早期。整个研究人群的中位总生存期（OS）为26.5个月。小肠下部（空肠、回肠和阑尾）肿瘤患者的OS优于上部SBA患者（分别为40个月和26个月；P=0.09）。原发肿瘤部位和分期是OS的独立预测因素。
我们的结果提示原发肿瘤部位具有预后作用。这一发现值得进一步研究，以确保对SBA进行更好的分类以及更有效的管理策略。
