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.
Keywords
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Article Info
Publication History
Published online: November 30, 2021
Accepted:
November 22,
2021
Received in revised form:
October 21,
2021
Received:
August 26,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Elsevier Inc. All rights reserved.
