[Diagnosis, treatment and prognosis of patients with small bowel adenocarcinoma in Landspítali University Hospital 2002-2021].

Abstract

Background: Small intestine adenocarcinoma is a rare cancer with poor prognosis. The only curative treatment is surgery to remove the tumor. If the tumor is located in the duodenum, a pancreaticoduodenectomy is recommended, while partial resection of the small intestine is advised for tumors located more distally.

Materials and methods: Data was obtained from the medical records system at Landspítali. Variables were recorded in Excel, and descriptive statistics along with survival calculations were performed using the statistical software R.

Results: A total of 47 patients were diagnosed with small intestine adenocarcinoma, 32 in the duodenum and 15 more distally. Curative surgery was performed on 25 patients. Severe complications (≥3 on the Clavien-Dindo scale) occurred in 32% of cases. The recurrence rate was 24%. One-year survival for patients undergoing surgery was 80%, while five-year survival rate was 56%. Five-year survival was higher for tumors originating in the duodenum (70,6%) compared to other parts of the small intestine (25,0% p>0,05).

Conclusion: Small intestine adenocarcinoma is a rare condition, with few patients diagnosed during the study period. A high proportion of patients underwent surgery, but one out of every four was diagnosed with recurrence during follow-up. No previous results for small intestine cancer in Iceland have been published, making comparisons with other countries difficult due to the low incidence of this cancer.