Primary tumors of the small intestine

In our department of surgery 28 patients with malignant and 10 with benign tumors of the small intestine were treated from 1940 to 1974. Fifteen patients with malignant and 7 with benign tumors underwent surgery with the intention to cure. Palliative operations or explorations were carried out on 13 patients with malignant tumors. Three patients with benign tumors were not operated on. The initial symptoms were vague: abdominal pain, nausea, anemia or bleeding in 75 and 80 percent of patients with malignant and benign tumors, respectively. The indication for operation in the malignant cases was, however, stenosis of the intestine or biliary tract or a palpable mass in 60 percent of the cases. At operation the tumors were thus in an advanced stage. Because the initial symptoms are vague, early diagnosis is difficult. The overall 5 year survival rate was 21 percent after surgery for malignant tumors. Among the patients considered by the surgeons to have had radical operations excluding cancer patients, 40 percent survived 5 years. The surgeon's opinion regarding "radical" operation as well as the presence or absence of metastases at microscopy were of limited prognostic value.