{"title":"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。","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":"<p><strong>Background: </strong>The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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":"{\"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\":\"<p><strong>Background: </strong>The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"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}","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}
Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan.
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.
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.
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