Malignant tumors of the small bowel
Authors:
L. Němec 1; P. Fabian 2; J. Tomášek 3; J. Jarkovský 4
; R. Šefr 1; L. Fiala 1
Authors place of work:
Klinika operační onkologie LF Masarykovy univerzity a Masarykova onkologického ústavu Brno
přednosta doc. MUDr. R. Šefr, Ph. D.
1; Oddělení onkologické patologie, Masarykův onkologický ústav Brno
primář MUDr. P. Fabian, Ph. D.
2; Klinika komplexní onkologické péče LF Masarykovy univerzity a Masarykova onkologického ústavu Brno
přednosta prof. MUDr. R. Vyzula, CSc.
3; Institut biostatistiky a analýz Masarykovy univerzity Brno
ředitel doc. RNDr. L. Dušek, Ph. D.
4
Published in the journal:
Rozhl. Chir., 2017, roč. 96, č. 6, s. 252-259.
Category:
Original articles
Summary
Introduction:
Malignant tumors of the small bowel are relatively uncommon neoplasms; their incidence is around 1.5 per 100,000 inhabitants in the Czech Republic.
Method:
104 patients underwent a resection of the small bowel because of a primary or secondary tumor over the 10-year period between 2006−2015 at the Masaryk Memorial Cancer Institute. Data from these patients was reviewed retrospectively. Survival rates were analyzed using the Kaplan-Meier method.
Results:
We observed 45 primary and 59 secondary tumors. The group of primary malignancies included 12 adenocarcinomas, 14 cases of GIST and 19 cases of NET. Neuroendocrine tumors showed the best prognosis with a 62% probability of five-year survival. Patients with gastrointestinal stromal tumors had a 39% probability of five-year survival and those with adenocarcinomas had a 32% probability of five-year survival. Secondary tumors were caused mostly by metastatic colorectal carcinoma (22 times), malignant melanoma (11 times) and ovarian cancer (10 times). The probability of five-year survival was 15% in the group of secondary tumors.
Conclusion:
Malignant tumors of the small intestine are rare, but their incidence has increased in the last decades. The main prognostic factors include advancement of the tumor and radicality of surgical resection.
Key words:
small bowel tumors – adenocarcinoma – sarcoma – NET – GIST – lymphoma
Zdroje
1. Becker HD, Hohenberger W, Junginger T, et al. Chirurgická onkologie, Praha, Grada Publishing 2005.
2. Krška Z, Hoskovec D, Petruželka L, et al. Chirurgická onkologie, Praha, Grada Publishing 2014.
3. Tomášek J. Benigní a maligní nádory tenkého střeva, Postgrad gastroenter hepatol 2016;1:2−8.
4. Abbott S, Nikolousis E, Badger I. Intestinal lymphoma—a review of the management of emergency presentations to the general surgeon. Int J Colorectal Dis 2015;30:151–7.
5. Howe JR, Karnell LH, Menck HR, et al. Adenocarcinoma of the small bowel. Cancer 1999;12:2693–706.
6. Chow WH, Linet MS, McLaughlin JK, et al. Risk factors for small intestine cancer. Cancer Causes Control 1993;4:163−9.
7. Bennett CM, Coleman HG, Veal PG, et al. Lifestyle factors and small intestine adenocarcinoma risk: A systematic review and meta-analysis. Cancer Epidemiol 2015;3:265−73.
8. Dasari BVM, Keith R, Gardiner KR. Management of adenocarcinoma of the small intestine. Gastrointest Cancer Res 2009;3:121−2.
9. Marchettini P, Sugarbaker PH. Mucinous adenocarcinoma of the small bowel with peritoneal seeding. Eur J Surg Oncol 2002;28:19–23.
10. Jacks SP, Hundley JC, Shen P, et al. Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma. J Surg Oncol 2005;91:112–7.
11. Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008; 9:61−72.
12. Oberndorfer S. Karzinoide Tumoren des Dünndarms. Frankfurt Z Pathol 1907;1:426−32.
13. Kloppel G, Perren A, Heitz PU. The gastroenteropancreatic neuroendocrine cell system and its tumors: the WHO classification. Ann N Y Acad Sci 2004;1014:13−27.
14. Bajčiová V, Tomášek J, Štěrba J, et al. Nádory adolescentů a mladých dospělých, Praha, Grada Publishing 2011.
15. Shebani KO, Souba WW, Finkelstein DM, et al. Prognosis and survival in patients with gastrointestinal tract carcinoid tumors. Ann Surg 1999;6:815.
16. Strosberg J, Goldman J, Costa, et al. The role of chemotherapy in well-differentiated gastroenteropancreatic neuroendocrine tumors. Front Horm Res 2015;44:239−47.
17. van Essen M, Krenning EP, De Jong M, et al. Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues in patients with somatostatin receptor positive tumours. Acta Oncol 2007;6:723−34.
18. Wu L, Fu J, Wan L, et al. Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study. Oncotarget 2017;3:4935−47.
19. Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 2006;10:1466–78.
20. Bednarski BK, Pisters PWT, Hunt KK. The role of surgery in the multidisciplinary management of patients with localized gastrointestinal stromal tumors. Expert Rev Anticancer Ther 2012;12:1069–78.
21. Fiala L, Šefr R, Kocáková I, et al. Léčba gastrointestinálních stromálních tumorů – komplexní pohled chirurga, Rozhl Chir 2015;94:189–92.
22. Páral J, Lochman P, Kalábová H, et al. GIST: Novodobé poznatky a léčebné modality. Rozhl Chir 2012;4:189.
23. Neuhaus SJ, Clark MA, Hayes AJ, et al. Surgery for gastrointestinal stromal tumour in the post-imatinib era. ANZ J Surg 2005;75:165−72.
24. Schwameis K, Fochtmann A, Schwameis M, et al. Surgical treatment of GIST− an institutional experience of a high-volume center. Int J Surg 2013;9:801−6.
25. Blanke CD, Demetri GD, von Mehren M, et al. Long-term results from a randomized phase II trial of standard-versus higherdose imatinib mesylate for patients with unresectable or metastatic gastrointestinal stromal tumors expressing KIT. J Clin Oncol 2008;26:620–5.
26. Dagher R, Cohen M, Williams G, et al. Approval summary: imatinib mesylate in the treatment of metastatic and/or unresectable malignant gastrointestinal stromal tumors. Clin Cancer Res 2002;10:3034−8.
27. Yamamoto H, Handa M, Tobo T, et al. Clinicopathological features of primary leiomyosarcoma of the gastrointestinal tract following recognition of gastrointestinal stromal tumours. Histopathology 2013;63:194–207.
28. Weledji EP, Enoworock G, Ngowe MN. Gastric leiomyosarcoma as a rare cause of gastric outlet obstruction and perforation: a case report. BMC Res Notes 2014;7:479.
29. Aggarwal G, Sharma S, Zheng M, et al. Primary leiomyosarcomas of the gastrointestinal tract in the postgastrointestinal stromal tumor era. Ann Diagn Pathol 2012;16:532–40.
30. Guzel T, Mech K, Mazurkiewicz M, et al. A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review. World J Surg Oncol 2016;14:48.
31. Skandalakis JE, Gray SW, Skandalakis LJ. Metastasis of malignant smooth muscle tumors of the gastrointestinal tract: pattern and process. J Med Assoc Ga 1991;80:701−9.
32. Kasper B, Reichardt P, Pink D, et al. Combination of trabectedin and gemcitabine for advanced soft tissue sarcomas: results of a phase I dose escalating trial of the German Interdisciplinary Sarcoma Group (GISG). Mar Drugs 2015;13:379–88.
33. Chunwei X, Hongyan H, Jingjing W, et al. Diagnosis value of CD117 and PDGFRA, alone or in combination DOG1, as biomarkers for gastrointestinal stromal tumors. Ann Transl Med 2015;20:308.
34. Licht JD, Weissmann LB, Antman K. Gastrointestinal sarcomas. Semin Oncol 1988;15:181–8.
35. O’Riordan BG, Vilor M, Herrera L. Small bowel tumors: an overview. Dig Dis 1996;14:245–57.
36. Adámková-Krákorová D. Systémová léčba sarkomů měkkých tkání, Postgrad med 2014;3:243−6.
37. Rossi A, Lister TA. Primary gastric non-Hodgkin´s lymphoma: a therapeutic challenge. Eur J Cancer 1993; 29A:1924–6.
38. Bečvářová Z, Voller J. Primární gastroinestinální lymfomy – chirurgické komplikace. Přehled a kazuistika. Plzeňský lékařský sborník 2016,82:129–35.
39. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol 2011;6:697−707.
40. Vaidya R, Habermann TM, Donohue JH, et al. Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol 2013;9:2439–43.
41. Nakamura S, Matsumoto T. Gastrointestinal lymphoma: recent advances in diagnosis and treatment. Digestion 2013;87:182–8.
42. Lightner AL, Shannon E, Gibbons MM, et al. Primary gastrointestinal non-Hodgkin’s lymphoma of the small and large intestines: a systematic review. J Gastrointest Surg 2016;4:827–39.
43. Janíková A, Michalka J, Šálek D, et al. Folikulární lymfom a další indolentní B-lymfomy. Postgrad med 2011;3:269−75.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2017 Číslo 6
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Obstructed defecation syndrome – review article
- Malignant tumors of the small bowel
- Surgical therapy of ovarian cancer
- Total pelvic exenteration – strategy and extent of surgery