학술논문
Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study
Document Type
article
Author
Yoshitaka Nishikawa; Takahiro Horimatsu; 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; Fumihiko Fujita; Hiroaki Ikematsu; Masaaki Ito; Motohiro Esaki; Masaya Kawai; Takashi Yao; Madoka Hamada; 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
Source
JCO Global Oncology, Vol , Iss 10 (2024)
Subject
Language
English
ISSN
2687-8941
Abstract
PURPOSELimited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA.METHODSThis retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests.RESULTSData from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively.CONCLUSIONPatients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.