JCO Global Oncology (Feb 2024)
Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study
- Yoshitaka Nishikawa,
- Takahiro Horimatsu,
- Shiro Oka,
- Takeshi Yamada,
- Keigo Mitsui,
- Hironori Yamamoto,
- Keiichi Takahashi,
- Akio Shiomi,
- Kinichi Hotta,
- Yoji Takeuchi,
- Toshio Kuwai,
- Fumio Ishida,
- Shin-Ei Kudo,
- Shoichi Saito,
- Masashi Ueno,
- Eiji Sunami,
- Tomoki Yamano,
- Michio Itabashi,
- Kazuo Ohtsuka,
- Yusuke Kinugasa,
- Takayuki Matsumoto,
- Tamotsu Sugai,
- Toshio Uraoka,
- Koichi Kurahara,
- Shigeki Yamaguchi,
- Tomohiro Kato,
- Masazumi Okajima,
- Hiroshi Kashida,
- Fumihiko Fujita,
- Hiroaki Ikematsu,
- Masaaki Ito,
- Motohiro Esaki,
- Masaya Kawai,
- Takashi Yao,
- Madoka Hamada,
- Keiji Koda,
- Yasumori Fukai,
- Koji Komori,
- Yusuke Saitoh,
- Yukihide Kanemitsu,
- Hiroyuki Takamaru,
- Kazutaka Yamada,
- Hiroaki Nozawa,
- Tetsuji Takayama,
- Kazutomo Togashi,
- Eiji Shinto,
- Takehiro Torisu,
- Akira Toyoshima,
- Naoki Ohmiya,
- Takeshi Kato,
- Eigo Otsuji,
- Shinji Nagata,
- Yojiro Hashiguchi,
- Kenichi Sugihara,
- Yoichi Ajioka,
- Shinji Tanaka
Affiliations
- Yoshitaka Nishikawa
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
- Takahiro Horimatsu
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
- Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan
- Takeshi Yamada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
- Keigo Mitsui
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
- Hironori Yamamoto
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan
- Keiichi Takahashi
- Department of Colorectal Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
- Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan
- Kinichi Hotta
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
- Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
- Toshio Kuwai
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
- Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
- Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
- Shoichi Saito
- Department of Lower Gastrointestinal Medicine, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
- Masashi Ueno
- Department of Gastroenterological and Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
- Eiji Sunami
- Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan
- Tomoki Yamano
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
- Michio Itabashi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
- Kazuo Ohtsuka
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
- Yusuke Kinugasa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
- Tamotsu Sugai
- Department of Diagnostic Pathology, Iwate Medical University, Iwate, Japan
- Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan
- Koichi Kurahara
- Division of Gastroenterology, Matsuyama Red Cross Hospital, Ehime, Japan
- Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
- Tomohiro Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
- Masazumi Okajima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
- Hiroshi Kashida
- Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan
- Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
- Hiroaki Ikematsu
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
- Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan
- Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
- Masaya Kawai
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
- Takashi Yao
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Madoka Hamada
- Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Osaka, Japan
- Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
- Yasumori Fukai
- Department of Gastroenterology, Maebashi Red Cross Hospital, Gunma, Japan
- Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
- Yusuke Saitoh
- Department of Gastroenterology, Asahikawa City Hospital, Asahikawa, Japan
- Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
- Hiroyuki Takamaru
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
- Kazutaka Yamada
- Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan
- Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
- Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Kazutomo Togashi
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
- Eiji Shinto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
- Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Akira Toyoshima
- Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
- Naoki Ohmiya
- Department of Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan
- Takeshi Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Shinji Nagata
- Department of Gastroenterology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
- Yojiro Hashiguchi
- Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan
- Kenichi Sugihara
- Tokyo Medical and Dental University, Tokyo, Japan
- Yoichi Ajioka
- Division of Molecular and Diagnostic Pathology Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Shinji Tanaka
- JA Onomichi General Hospital, Hiroshima, Japan
- DOI
- https://doi.org/10.1200/GO.23.00392
- Journal volume & issue
-
no. 10
Abstract
PURPOSELimited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA.METHODSThis retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests.RESULTSData from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively.CONCLUSIONPatients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.
