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Primary neoplasms of the small bowel
F Serour1, G Dona, S Birkenfeld
1Department of Surgery A, Edith Wolfson Medical Center, Holon, Israel.
Journal of Surgical Oncology
|January 1, 1992
Summary
Primary small bowel tumors are rare and often diagnosed late, leading to poor outcomes. Increased awareness is crucial for earlier detection and improved prognosis in these unusual gastrointestinal neoplasms.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Primary small bowel neoplasms are uncommon, accounting for 1-5% of all gastrointestinal tumors.
- These tumors present diagnostic challenges, often with advanced disease at diagnosis and a poor prognosis.
Purpose of the Study:
- To analyze the clinical characteristics, diagnostic methods, and outcomes of patients with primary small bowel tumors.
- To identify factors contributing to the poor prognosis and emphasize the need for earlier diagnosis.
Main Methods:
- Retrospective review of 61 patients treated for small bowel tumors over 26 years.
- Analysis of presenting symptoms, diagnostic modalities (including small intestinal barium studies), surgical interventions, and survival rates.
Main Results:
- Abdominal pain, weight loss, and gastrointestinal bleeding were the most common symptoms.
- Malignancies included lymphoma (38.6%), adenocarcinoma (29.6%), and leiomyosarcoma (22.8%). Lymphoma was more prevalent in Sephardic Jews.
- High postoperative mortality (20% benign, 14% malignant) and a 5-year survival of 18% for malignant tumors were observed, linked to late diagnosis and emergency presentations.
Conclusions:
- Late diagnosis due to nonspecific symptoms and diagnostic difficulties contributes to the poor prognosis of small bowel tumors.
- Earlier detection through increased clinical awareness is essential to improve patient outcomes.