Current Oncologic Standards for Surgery of Small Bowel Cancers

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Cancer Research

Background:

• Recent decades show increased efforts to standardize small bowel cancer surgery.
• Current guidelines stem from high-volume centers of excellence.
• Replicability of these guidelines in single-center settings remains to be evaluated.

Purpose of the Study:

• To assess if recent oncologic recommendations for small bowel cancer surgery can be reproduced by a single surgical team.
• To evaluate the feasibility of applying standardized procedures and lymphadenectomy extent in a non-specialized center.

Main Methods:

• Retrospective analysis of 32 adult patients undergoing small bowel tumor surgery (2010-2019).
• Procedures and lymph node harvest were compared against current oncologic guidelines.
• Focus on tumors of the duodenum, jejunum, and ileum.

Main Results:

• 29 of 32 patients had small bowel cancers; duodenum was the most frequent site, and neuroendocrine tumors (NET) the most common diagnosis.
• Whipple's procedure for duodenal tumors and segmental resection for others were performed.
• Median lymph node examination: 14 for duodenal adenocarcinoma, 9 for NET, and 11 for jejunal/ileal adenocarcinoma.

Conclusions:

• The study demonstrates that recently proposed standards for small bowel cancer surgery are achievable.
• Adherence to fundamental principles of oncologic surgery facilitates the replication of these standards.
• Single-center teams can successfully implement advanced surgical guidelines for small bowel malignancies.