Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JS']JSCCR database in Japan

被引：1

作者：

Yamashita, Ken ^{[1
]}

Oka, Shiro ^{[1
]}

Yamada, Takeshi ^{[2
]}

Mitsui, Keigo ^{[3
]}

Yamamoto, Hironori ^{[4
]}

Takahashi, Keiichi ^{[5
]}

Shiomi, Akio ^{[6
]}

Hotta, Kinichi ^{[7
]}

Takeuchi, Yoji ^{[8
]}

Kuwai, Toshio ^{[9
]}

Ishida, Fumio ^{[10
]}

Kudo, Shin-Ei ^{[10
]}

Saito, Shoichi ^{[11
]}

Ueno, Masashi ^{[12
]}

Sunami, Eiji ^{[13
]}

Yamano, Tomoki ^{[14
]}

Itabashi, Michio ^{[15
]}

Ohtsuka, Kazuo ^{[16
]}

Kinugasa, Yusuke ^{[17
]}

Matsumoto, Takayuki ^{[18
]}

Sugai, Tamotsu ^{[19
]}

Uraoka, Toshio ^{[20
]}

Kurahara, Koichi ^{[21
]}

Yamaguchi, Shigeki ^{[22
]}

Kato, Tomohiro ^{[23
]}

Okajima, Masazumi ^{[24
]}

Kashida, Hiroshi ^{[25
]}

Akagi, Yoshito ^{[26
]}

Ikematsu, Hiroaki ^{[27
]}

Ito, Masaaki ^{[28
]}

Esaki, Motohiro ^{[29
]}

Kawai, Masaya ^{[30
]}

Yao, Takashi ^{[31
]}

Hamada, Madoka ^{[32
]}

Horimatsu, Takahiro ^{[33
]}

Koda, Keiji ^{[34
]}

Fukai, Yasumori ^{[35
]}

Komori, Koji ^{[36
]}

Saitoh, Yusuke ^{[37
]}

Kanemitsu, Yukihide ^{[38
]}

Takamaru, Hiroyuki ^{[39
]}

Yamada, Kazutaka ^{[40
]}

Nozawa, Hiroaki ^{[41
]}

Takayama, Tetsuji ^{[42
]}

Togashi, Kazutomo ^{[43
]}

Shinto, Eiji ^{[44
]}

Torisu, Takehiro ^{[45
]}

Toyoshima, Akira ^{[46
]}

Ohmiya, Naoki ^{[47
]}

Kato, Takeshi ^{[48
]}

机构：

[1] Hiroshima Univ Hosp, Dept Gastroenterol, 1-2-3 Kasumi,Minami Ku, Hiroshima 7348551, Japan

[2] Nippon Med Sch, Dept Gastrointestinal Hepatobiliary Pancreat Surg, Tokyo, Japan

[3] Nippon Med Sch, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[4] Jichi Med Univ, Dept Med, Div Gastroenterol, Tochigi, Japan

[5] Tokyo Metropolitan Canc & Infect Dis Ctr, Komagome Hosp, Dept Colorectal Surg, Tokyo, Japan

[6] Shizuoka Canc Ctr, Div Colon & Rectal Surg, Shizuoka, Japan

[7] Shizuoka Canc Ctr, Div Endoscopy, Shizuoka, Japan

[8] Osaka Int Canc Inst, Dept Gastrointestinal Oncol, Osaka, Japan

[9] Natl Hosp Org Kure Med Ctr, Dept Gastroenterol, Hiroshima, Japan

[10] Showa Univ, Northern Yokohama Hosp, Digest Dis Ctr, Kanagawa, Japan

[11] Japanese Fdn Canc Res, Dept Lower Gastrointestinal Med, Canc Inst Hosp, Tokyo, Japan

[12] Toranomon Gen Hosp, Dept Gastroenterol Surg, Tokyo, Japan

[13] Kyorin Univ, Sch Med, Dept Surg, Tokyo, Japan

[14] Hyogo Coll Med, Dept Surg, Div Lower Gastrointestinal Surg, Nishinomiya, Hyogo, Japan

[15] Tokyo Womens Med Univ, Inst Gastroenterol, Dept Surg, Tokyo, Japan

[16] Tokyo Med & Dent Univ, Dept Gastroenterol & Hepatol, Tokyo, Japan

[17] Tokyo Med & Dent Univ, Dept Gastrointestinal Surg, Tokyo, Japan

[18] Iwate Med Univ, Dept Internal Med, Div Gastroenterol, Morioka, Iwate, Japan

[19] Iwate Med Univ, Dept Diagnost Pathol, Yahaba, Iwate, Japan

[20] Gunma Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Gunma, Japan

[21] Matsuyama Red Cross Hosp, Div Gastroenterol, Matsuyama, Ehime, Japan

[22] Saitama Med Univ, Int Med Ctr, Dept Gastroenterol Surg, Saitama, Japan

[23] Jikei Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol, Tokyo, Japan

[24] Hiroshima City Hiroshima Citizens Hosp, Dept Surg, Hiroshima, Japan

[25] Kindai Univ, Dept Gastroenterol & Hepatol, Fac Med, Osaka, Japan

[26] Kurume Univ, Sch Med, Dept Surg, Fukuoka, Japan

[27] Natl Canc Ctr Hosp East, Dept Gastroenterol & Endoscopy, Chiba, Japan

[28] Natl Canc Ctr Hosp East, Dept Colorectal Surg, Chiba, Japan

[29] Saga Univ, Fac Med, Dept Internal Med, Div Gastroenterol, Saga, Japan

[30] Juntendo Univ, Fac Med, Dept Coloproctol Surg, Tokyo, Japan

[31] Juntendo Univ, Grad Sch Med, Dept Human Pathol, Tokyo, Japan

[32] Kansai Med Univ Hosp, Dept Gastrointestinal Surg, Osaka, Japan

[33] Kyoto Univ Hosp, Dept Clin Oncol, Kyoto, Japan

[34] Teikyo Univ, Chiba Med Ctr, Dept Surg, Chiba, Japan

[35] Maebashi Red Cross Hosp, Dept Gastroenterol, Gunma, Japan

[36] Aichi Canc Ctr Hosp, Dept Gastroenterol Surg, Aichi, Japan

[37] Asahikawa City Hosp, Dept Gastroenterol, Asahikawa, Hokkaido, Japan

[38] Natl Canc Ctr, Dept Colorectal Surg, Tokyo, Japan

[39] Natl Canc Ctr, Div Endoscopy, Tokyo, Japan

[40] Takano Hosp, Dept Surg, Coloproctol Ctr, Kumamoto, Japan

[41] Univ Tokyo, Dept Surg Oncol, Tokyo, Japan

[42] Tokushima Univ, Grad Sch Biomed Sci, Dept Gastroenterol & Oncol, Tokushima, Japan

[43] Fukushima Med Univ, Aizu Med Ctr, Dept Coloproctol, Fukushima, Japan

[44] Natl Def Med Coll, Dept Surg, Tokorozawa, Saitama, Japan

[45] Kyushu Univ, Grad Sch Med Sci, Dept Med & Clin Sci, Fukuoka, Japan

[46] Japanese Red Cross Med Ctr, Dept Colorectal Surg, Tokyo 1508935, Japan

[47] Fujita Hlth Univ, Sch Med, Dept Adv Endoscopy, Toyoake, Aichi, Japan

[48] Natl Hosp Org Osaka Natl Hosp, Dept Surg, Osaka, Japan

[49] Kyoto Prefectural Univ Med, Dept Surg, Div Digest Surg, Kyoto, Japan

[50] Hiroshima City North Med Ctr Asa Citizens Hosp, Dept Gastroenterol, Hiroshima, Japan

来源：

JOURNAL OF GASTROENTEROLOGY | 2024年 / 59卷 / 05期

关键词：

Primary small bowel adenocarcinoma; Capsule endoscopy; Double-balloon endoscopy; Lynch syndrome; Prognosis; SMALL-INTESTINE; CAPSULE ENDOSCOPY; CANCER; SURVIVAL; EPIDEMIOLOGY; DIAGNOSIS;

D O I：

10.1007/s00535-024-02081-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundThe clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.MethodsWe analyzed 354 patients with 358 PSBAs, between January 2008 and December 2017, at 44 institutions affiliated with the Japanese Society for Cancer of the Colon and Rectum.ResultsThe median age was 67 years (218 males, 61.6%). The average tumor size was 49.9 (7-100) mm. PSBA sites consisted of jejunum (66.2%) and ileum (30.4%). A total of 219 patients (61.9%) underwent diagnostic small bowel endoscopy, including single-balloon endoscopy, double-balloon endoscopy, and capsule endoscopy before treatment. Nineteen patients (5.4%) had Lynch syndrome, and 272 patients (76.8%) had symptoms at the initial diagnosis. The rates for stages 0, I, II, III, and IV were 5.4%, 2.5%, 27.1%, 26.0%, and 35.6%, respectively. The 5-year overall survival rates at each stage were 92.3%, 60.0%, 75.9%, 61.4%, and 25.5%, respectively, and the 5-year disease-specific survival (DSS) rates were 100%, 75.0%, 84.1%, 59.3%, and 25.6%, respectively. Patients with the PSBA located in the jejunum, with symptoms at the initial diagnosis or advanced clinical stage had a worse prognosis. However, multivariate analysis using Cox-hazard model revealed that clinical stage was the only significant predictor of DSS for patients with PSBA.ConclusionsOf the patients with PSBA, 76.8% had symptoms at the initial diagnosis, which were often detected at an advanced stage. Detection during the early stages of PSBA is important to ensure a good prognosis.

引用

页码：376 / 388

页数：13

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