Small bowel adenocarcinoma: results from a nationwide prospective ARCAD-NADEGE cohort study of 347 patients.
Fiche publication
Date publication
janvier 2020
Journal
International journal of cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BOUCHE Olivier, Dr VERNEREY Dewi, Pr MANFREDI Sylvain, Mme HENRIQUES Julie
Tous les auteurs :
Aparicio T, Henriques J, Manfredi S, Tougeron D, Bouché O, Pezet D, Piessen G, Coriat R, Zaanan A, Legoux JL, Terrebone E, Pocard M, Gornet JM, Lecomte T, Lombard-Bohas C, Perrier H, Lecaille C, Lavau-Denes S, Vernerey D, Afchain P,
Lien Pubmed
Résumé
Small bowel adenocarcinoma (SBA) is a rare tumour. We conducted a prospective cohort to describe the prevalence, survival, and prognostic factors in unselected SBA patients. The study enrolled patients with all stages of newly diagnosed or recurrent SBA at 74 French centres between January 2009 and December 2012. In total, 347 patients were analysed; the median age was 63 years (range: 23-90). The primary tumour was in the duodenum (60.6%), jejunum (20.7%), and ileum (18.7%). The prevalence of predisposing disease was 8.7%, 6.9%, 1.7%, 1.7%, and 0.6% for Crohn disease, Lynch syndrome, familial adenomatous polyposis, celiac disease, and Peutz-Jeghers syndrome, respectively. At diagnosis, 58.9%, 5.5%, and 35.6% of patients had localized and resectable, locally advanced unresectable, and metastatic disease, respectively. Crohn disease was significantly associated with younger age, poor differentiation, and ileum location, whereas Lynch syndrome with younger age, poor differentiation, early stage, and duodenum location. Adjuvant chemotherapy (oxaliplatin-based in 89.9%) was performed in 61.5% of patients with locally resected tumours. With a 54 months median follow-up, the 5-year overall survival (OS) was 87.9%, 78.2%, and 55.5% in stage I, II, and III, respectively. The median OS of patients with stage IV was 12.7 months. In patients with resected tumours, poor differentiation (p=0.047) and T4 stage (p=0.001) were associated with a higher risk of death. In conclusion, this study showed that the prognosis of advanced SBA remains poor. Tumour characteristics differed according to predisposing disease. In SBA resected tumours , the prognostic factors for OS were grade and T stage. This article is protected by copyright. All rights reserved.
Mots clés
Crohn disease, Lynch syndrome, cohort study, epidemiology, small intestine adenocarcinoma
Référence
Int. J. Cancer. 2020 Jan 7;: