Yang Zhen, Xu Haibin, Li Luan, Leng Kaiming, Shi Guangjun
Department of Hepatopancreatobiliary Surgery, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), China.
J Gastroenterol Hepatol. 2024 Dec;39(12):2597-2608. doi: 10.1111/jgh.16740. Epub 2024 Sep 16.
Population-based studies comparing clinical characteristics and survival disparities between patients with small bowel adenocarcinoma (SBA) and small bowel neuroendocrine tumors (SBNETs) in the United States are limited.
Data for patients with SBA or SBNETs, obtained from the Surveillance, Epidemiology, and End Results database for the years between 2000 and 2018 were analyzed.
Between 2000 and 2018, the age-adjusted incidence of SBA experienced a marginal increase whereas SBNETs demonstrated a significant increase, emerging as the predominant subtype of small bowel cancer (SBC). Diagnoses peaked at ages 65-69 years for SBA and 60-64 years for SBNETs, with the latter exhibiting a heightened age-specific incidence and maintaining equilibrium in gender distribution. Clinicopathologic disparities revealed SBA's duodenal predilection, larger tumor size, and advanced stages, contrasting with SBNETs' ileal predilection, early-stage presentation, and superior outcomes. SBNETs patients underwent surgery more frequently but received less chemotherapy and radiation than SBA patients. Factors intricately correlated with a diagnosis of SBNETs included female gender, White race, advanced age, marital status, recent diagnoses, superior tumor differentiation, smaller size, distal location, and early-stage presentation. Survival analysis unveiled a remarkable 79% reduction in the mortality risk for SBNETs compared with SBA. Subgroup analysis further confirmed the consistently favorable survival advantages of SBNETs, highlighting the clinical relevance of histological classification in prognostication.
Compared with SBA, SBNETs exhibited distinctive clinicopathological features characterized by a higher inclination toward low-grade and early-stage manifestations, thereby contributing to superior survival outcomes.
在美国，基于人群比较小肠腺癌（SBA）和小肠神经内分泌肿瘤（SBNETs）患者临床特征及生存差异的研究有限。
分析了2000年至2018年间从监测、流行病学和最终结果数据库中获取的SBA或SBNETs患者的数据。
2000年至2018年间，SBA的年龄调整发病率略有上升，而SBNETs则显著上升，成为小肠癌（SBC）的主要亚型。SBA的诊断高峰年龄为65 - 69岁，SBNETs为60 - 64岁，后者的年龄别发病率更高，且性别分布保持平衡。临床病理差异显示，SBA好发于十二指肠，肿瘤较大且分期较晚，而SBNETs好发于回肠，呈早期表现且预后较好。与SBA患者相比，SBNETs患者更常接受手术，但接受的化疗和放疗较少。与SBNETs诊断密切相关的因素包括女性、白种人、高龄、婚姻状况、近期诊断、肿瘤分化程度高、体积小、远端位置及早期表现。生存分析显示，与SBA相比，SBNETs的死亡风险显著降低79%。亚组分析进一步证实了SBNETs持续良好的生存优势，突出了组织学分类在预后判断中的临床相关性。
与SBA相比，SBNETs表现出独特的临床病理特征，倾向于低级别和早期表现，从而导致更好的生存结果。
