European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2018
Resection of small bowel adenocarcinoma metastases: Results of the ARCAD-NADEGE cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Rompteaux Pierre, Gagnière Johan, Gornet Jean-Marc, Coriat Romain, Baumgaertner Isabelle, Lecomte Thierry, Afchain Pauline, Zaanan Aziz, Pocard Marc, Bachet Jean-Baptiste, Bonichon-Lamichhane Nathalie, Bouché Olivier, Faucheron Jean-Luc, Forestier Julien, Lecaille Cedric, Manfredi Sylvain, Tougeron David, Terrebonne Eric, Chehimi Mohamad, Villing Anne-Laure, Sarda Corinne, Legoux Jean-Louis, Benamouzig Robert, Aparicio Thomas
Аннотация
INTRODUCTION: Data are lacking with regard to curative resection of metastasis from small bowel adenocarcinoma (SBA). This study evaluated outcomes and prognostic factors in patients with curatively resected metastatic SBA.
METHODS: A series of 34 patients undergoing resection of metastatic SBA from January 2009 to November 2014 at French centers were included into this cohort study. The primary endpoint was overall survival (OS). Secondary endpoints were recurrence-free survival (RFS) and prognostic factors. Univariate analyses were performed to determine prognostic risk factors.
RESULTS: The sites of SBA metastases were peritoneal (29.4%), liver (26.5%), lymph nodes (11.8%), lung (2.9%), multiple (14.7%), and other (14.7%). Thirty (88.2%) patients received adjuvant or perioperative chemotherapy, mainly was oxaliplatin-based (76.5%). The median OS was 28.6 months and RFS was 18.7 months. Fourteen (41.2%) patients survived for more than 36 months. In univariate analysis, poor differentiation (P = 0.006), invaded margins (P = 0.003), and lymphatic invasion in the primary tumor (P = 0.039) were associated with decreased OS.
CONCLUSION: Overall survival of patients after resection of metastatic SBA remains poor, but long-term survivors are observed. Resection of metastatic SBA should be consider if patients are expected to be operated on with curative intent and have moderately or well-differentiated tumors.
METHODS: A series of 34 patients undergoing resection of metastatic SBA from January 2009 to November 2014 at French centers were included into this cohort study. The primary endpoint was overall survival (OS). Secondary endpoints were recurrence-free survival (RFS) and prognostic factors. Univariate analyses were performed to determine prognostic risk factors.
RESULTS: The sites of SBA metastases were peritoneal (29.4%), liver (26.5%), lymph nodes (11.8%), lung (2.9%), multiple (14.7%), and other (14.7%). Thirty (88.2%) patients received adjuvant or perioperative chemotherapy, mainly was oxaliplatin-based (76.5%). The median OS was 28.6 months and RFS was 18.7 months. Fourteen (41.2%) patients survived for more than 36 months. In univariate analysis, poor differentiation (P = 0.006), invaded margins (P = 0.003), and lymphatic invasion in the primary tumor (P = 0.039) were associated with decreased OS.
CONCLUSION: Overall survival of patients after resection of metastatic SBA remains poor, but long-term survivors are observed. Resection of metastatic SBA should be consider if patients are expected to be operated on with curative intent and have moderately or well-differentiated tumors.
Предметные рубрики MeSH
AdenocarcinomaAdultAgedAged, 80 and overAmpulla of VaterDigestive System Surgical ProceduresDisease-Free SurvivalDuodenal NeoplasmsFemaleFollow-Up StudiesFranceHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasm MetastasisNeoplasm StagingPositron Emission Tomography Computed TomographyPrognosisProspective StudiesSurvival Rate