Felipe Silva , Miguel Bustamante , Gonzalo Latorre , Jorge Flandez , Isabella Montero , Eitan Dukes , Vicente Gandara , Camila Robles , Javier Uribe , Andrés Iglesias , Felipe Bellolio , María Elena Molina , Rodrigo Migueles , Gonzalo Urrejola , Tomás Larach , Nicolas Besser , Allan Sharp , Carlos Agüero , Arnoldo Riquelme , José Ignacio Vargas , Alberto Espino
{"title":"Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile","authors":"Felipe Silva , Miguel Bustamante , Gonzalo Latorre , Jorge Flandez , Isabella Montero , Eitan Dukes , Vicente Gandara , Camila Robles , Javier Uribe , Andrés Iglesias , Felipe Bellolio , María Elena Molina , Rodrigo Migueles , Gonzalo Urrejola , Tomás Larach , Nicolas Besser , Allan Sharp , Carlos Agüero , Arnoldo Riquelme , José Ignacio Vargas , Alberto Espino","doi":"10.1016/j.gastrohep.2024.01.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America.</p></div><div><h3>Aim</h3><p>To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs.</p></div><div><h3>Methods</h3><p>Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile.</p></div><div><h3>Results</h3><p>A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, <em>n</em> <!-->=<!--> <!-->38), gastrointestinal stromal tumors (GIST) (21.8%, <em>n</em> <!-->=<!--> <!-->19), lymphoma (17.2%, <em>n</em> <!-->=<!--> <!-->15) and adenocarcinoma (AC) (11.5%, <em>n</em> <!-->=<!--> <!-->10). GIST was more frequent in duodenum (50%; <em>n</em> <!-->=<!--> <!-->12) and NET in the ileum (65.8%; <em>n</em> <!-->=<!--> <!-->25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC (<em>p</em> <!-->=<!--> <!-->0.035), as well as gastrointestinal bleeding in GIST (<em>p</em> <!-->=<!--> <!-->0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5-year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1–99.2), 82.2% (95%CI: 57.6–93.3), 40.0% (95%CI: 16.5–82.8) and 25.9% (95%CI: 4.5–55.7%), respectively. NET (HR 6.1; 95%CI: 2.1–17.2) and GIST (HR 24.4; 95%CI: 3.0–19.8) were independently associated with higher survival compared to AC, adjusted for age and sex.</p></div><div><h3>Conclusions</h3><p>Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes.</p></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterologia y hepatologia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0210570524000347","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America.
Aim
To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs.
Methods
Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile.
Results
A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n = 38), gastrointestinal stromal tumors (GIST) (21.8%, n = 19), lymphoma (17.2%, n = 15) and adenocarcinoma (AC) (11.5%, n = 10). GIST was more frequent in duodenum (50%; n = 12) and NET in the ileum (65.8%; n = 25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC (p = 0.035), as well as gastrointestinal bleeding in GIST (p = 0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5-year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1–99.2), 82.2% (95%CI: 57.6–93.3), 40.0% (95%CI: 16.5–82.8) and 25.9% (95%CI: 4.5–55.7%), respectively. NET (HR 6.1; 95%CI: 2.1–17.2) and GIST (HR 24.4; 95%CI: 3.0–19.8) were independently associated with higher survival compared to AC, adjusted for age and sex.
Conclusions
Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes.
期刊介绍:
Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.