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

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-02-27 DOI:10.1007/s00535-024-02081-3

Ken Yamashita, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Yoshito Akagi, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Takahiro Horimatsu, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka

{"title":"Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan.","authors":"Ken Yamashita, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Yoshito Akagi, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Takahiro Horimatsu, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka","doi":"10.1007/s00535-024-02081-3","DOIUrl":null,"url":null,"abstract":"Background: The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.Methods: We 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.Results: The 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.Conclusions: Of 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.","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"376-388"},"PeriodicalIF":6.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11033235/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00535-024-02081-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.

Methods: We 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.

Results: The 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.

Conclusions: Of 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.

Abstract Image

查看原文本刊更多论文

原发性小肠腺癌的临床病理特征和预后：日本 JSCCR 数据库的大型多中心分析。

背景：原发性小肠腺癌（不包括十二指肠癌）的临床病理特征和预后在日本仍未确定：原发性小肠腺癌（不包括十二指肠癌）的临床病理特征和预后因其在日本的罕见性仍未确定：我们分析了2008年1月至2017年12月期间，日本结肠直肠癌协会下属44家机构的354名358例原发性小肠腺癌患者：中位年龄为67岁（218名男性，61.6%）。肿瘤平均大小为 49.9（7-100）毫米。PSBA部位包括空肠（66.2%）和回肠（30.4%）。共有219名患者（61.9%）在治疗前接受了诊断性小肠内窥镜检查，包括单气囊内窥镜检查、双气囊内窥镜检查和胶囊内窥镜检查。19名患者（5.4%）患有林奇综合征，272名患者（76.8%）在初次诊断时有症状。0期、I期、II期、III期和IV期的发病率分别为5.4%、2.5%、27.1%、26.0%和35.6%。各期的 5 年总生存率分别为 92.3%、60.0%、75.9%、61.4% 和 25.5%，5 年疾病特异性生存率（DSS）分别为 100%、75.0%、84.1%、59.3% 和 25.6%。PSBA位于空肠、初诊时有症状或临床分期较晚的患者预后较差。然而，使用Cox-hazard模型进行的多变量分析显示，临床分期是预测PSBA患者DSS的唯一重要因素：结论：在 PSBA 患者中，76.8% 的患者在最初诊断时有症状，但往往在晚期才被发现。在 PSBA 早期阶段进行检测对于确保良好的预后非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.