肿瘤位置对小肠癌患者预后的影响

Impact of Tumor Location on Patient Outcomes in Small Bowel Cancers.

作者信息

Yu Irene S, Al-Hashami Zamzam, Chapani Parv, Speers Caroline, Davies Janine M, Lim Howard J, Renouf Daniel J, Gill Sharlene, Stuart Heather C, Loree Jonathan M

机构信息

BC Cancer, Vancouver, British Columbia, Canada.

University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Clin Colorectal Cancer. 2022 Jun;21(2):107-113. doi: 10.1016/j.clcc.2021.11.006. Epub 2021 Dec 1.

DOI:10.1016/j.clcc.2021.11.006

PMID:34972663

Abstract

BACKGROUND

Small bowel cancers are rare gastrointestinal malignancies and tumor location impact on outcomes is unclear.

MATERIAL AND METHODS

A retrospective review was performed on stage I to IV small bowel cancer cases from 2000 to 2017 in British Columbia, Canada. Baseline patient characteristics, disease-free survival (DFS) and overall survival (OS) were evaluated by tumor location and systemic therapy use patterns were summarized.

RESULTS

Of 340 patients included, primary tumor distribution was: duodenum (51.2%), ileum (19.1%), jejunum (18.5%), and unspecified (11.2%). Median DFS for stage I to III disease was 37.7, 49.1, and 26.7 months for duodenal, jejunal, and ileal tumors (P = .018). Median OS was 9.6, 35.2, and 20.1 months for duodenal, jejunal, and ileal tumors (P < .0001). Compared to duodenal primaries, both jejunal and ileal tumors were associated with significantly improved OS (HR 0.43, P < .001 for jejunal; HR 0.71, P = .035 for ileal). Adjuvant therapy was given to 21.6% of stage II and 50.6% of stage III cancers. Among patients with metastatic disease, median OS was 4.2, 11.4, and 6.9 months for duodenal, jejunal, and ileal tumors (P = .0019). Jejunal tumors had the best prognosis (HR 0.48, P = .001 vs. duodenum).

CONCLUSION

Survival differences exist when small bowel cancers were assessed by tumor location, and jejunal tumors portended better prognosis overall.

摘要

背景

小肠癌是罕见的胃肠道恶性肿瘤，肿瘤位置对预后的影响尚不清楚。

材料与方法

对2000年至2017年加拿大不列颠哥伦比亚省I至IV期小肠癌病例进行回顾性研究。通过肿瘤位置评估患者基线特征、无病生存期（DFS）和总生存期（OS），并总结全身治疗的使用模式。

结果

纳入的340例患者中，原发性肿瘤分布为：十二指肠（51.2%）、回肠（19.1%）、空肠（18.5%）和未明确部位（11.2%）。I至III期疾病的十二指肠、空肠和回肠肿瘤的中位DFS分别为37.7、49.1和26.7个月（P = 0.018）。十二指肠、空肠和回肠肿瘤的中位OS分别为9.6、35.2和20.1个月（P < 0.0001）。与十二指肠原发性肿瘤相比，空肠和回肠肿瘤的OS均显著改善（空肠：HR 0.43，P < 0.001；回肠：HR 0.71，P = 0.035）。21.6%的II期和50.6%的III期癌症患者接受了辅助治疗。在转移性疾病患者中，十二指肠、空肠和回肠肿瘤的中位OS分别为4.2、11.4和6.9个月（P = 0.0019）。空肠肿瘤预后最佳（与十二指肠相比，HR 0.48，P = 0.001）。