Retrospective analysis of 119 small bowel adenocarcinoma in Chinese patients.

Background: Small bowel adenocarcinoma (SBA) is a rare occurrence and few studies have addressed it adequately, especially in China. Methods: Clinicopathological features, survival and prognostic analysis were retrospectively done in SBA patients admitted between 2001 and 2011 in the People's Liberation Army General Hospital. Results: The study included 68 men and 51 women with a median age of 56.5 year. Tumors mainly occurred in duodenum (93.3%). Abdominal pain was the most frequent symptom(36.8%). Patients (30.3%) who received postoperative adjuvant chemotherapy had an increased, but not significant, median overall survival (MOS) rate compared to those who did not receive chemotherapy ( 37 vs 35months, p=. 324). One year disease free survival rate was higher in patients receiving postoperative chemotherapy (83.3% vs 71.1%). Patients survived longer in the curative surgery group ( median survival time of 49.0months) than those in the palliative group (7.0 months) (p<. 001). Node-negative patients survived longer than node-positive patients ( median OS: 49.0 vs 21.0months, p=. 004). Depth (95% CI: 1.013-1.517, p=. 037), node involvement ( 95% CI: 1.234-3.890, p=. 007), palliative surgery ( 95% CI, 2.998-10.555, p=. 0005), and the site of tumor ( 95% CI: 0.052-0.970, p=. 045) were independent predictors of OS in a multivariate analysis. Conclusions: SBA is rare and there is lack of obvious clinical manifestations. Depth, node involvement, palliative surgery, and the site of tumor are associated with a poor prognosis. Our analysis highlights the need for further studies to find out the exact role of postoperative adjuvant chemotherapy in these patients.