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Prognostic factors in resected primary small bowel tumors
B L Brücher1, J D Roder, U Fink
1Chirurgische Klinik and Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Deutschland. bruecher@ntl.chir.med.tu-muenchen.de
Digestive Surgery
|December 9, 1998
Summary
Surgical outcomes for primary small bowel tumors (SBT) show a 7% 30-day mortality and 31.8% 5-year survival for malignant cases. Complete tumor resection is crucial for curative surgical approaches in SBT patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Primary small bowel tumors (SBT) are rare, encompassing a diverse range of malignant and benign neoplasms.
- Malignant SBTs include adenocarcinomas, neuroendocrine tumors, lymphomas, and leiomyosarcomas, each with distinct characteristics.
- Understanding the surgical outcomes and prognostic factors for SBTs is essential for improving patient survival.
Purpose of the Study:
- To analyze the surgical outcomes and survival rates of patients with primary small bowel tumors.
- To identify prognostic factors influencing survival in patients undergoing surgery for SBT.
- To evaluate the impact of resection status on patient outcomes.
Main Methods:
- Retrospective analysis of 71 patients operated for primary small bowel tumors.
- Classification of tumors into malignant and benign categories, with further subtyping of malignant lesions.
- Statistical analysis to determine morbidity, mortality, survival rates, and prognostic factors.
Main Results:
- Malignant tumors constituted 66.2% of cases, with adenocarcinomas being the most frequent subtype.
- Surgical treatment resulted in 16.9% morbidity and 7% 30-day mortality.
- The estimated 5-year survival rate for malignant SBTs was 31.8%.
- Distant metastasis and R status (resection status) were significant prognostic factors (p=0.034 and p=0.001, respectively).
- T status, N status, and grading did not significantly influence survival.
Conclusions:
- Complete macroscopic and microscopic tumor resection should be the primary goal of curative surgical interventions for SBT.
- Early detection and complete resection are critical for improving the prognosis of patients with malignant small bowel tumors.
- Further research into multimodal treatment strategies may be warranted for unresectable or metastatic SBTs.