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Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine.

Publication ,  Journal Article
Overman, MJ; Kopetz, S; Lin, E; Abbruzzese, JL; Wolff, RA
Published in: Acta Oncol
May 2010

BACKGROUND: The benefit of adjuvant therapy for resected small bowel adenocarcinoma has not been proven. We undertook a retrospective analysis to evaluate the benefit of adjuvant therapy in a clearly defined patient population with curatively resected small bowel adenocarcinoma. MATERIAL AND METHODS: We identified 54 patients with small bowel adenocarcinoma who underwent margin-negative surgical resection and were evaluated after surgery at the University of Texas, M. D. Anderson Cancer Center between 1990 and 2008. Disease-free survival (DFS) and overall survival (OS) were estimated. RESULTS: Median age was 55 years and primary tumor site was duodenum in 67%, jejunum in 20%, and ileum in 13%. Thirty patients (56%) received adjuvant therapy consisting of systemic chemotherapy with or without radiation in 28 and radiation alone in two. Patients who received adjuvant therapy had significantly higher tumor stage and rate of lymph node involvement. Five-year DFS and OS did not differ between treatment groups. In multivariate analysis, the use of adjuvant therapy was associated with improved DFS (HR 0.27; 95% CI 0.07-0.98, P = 0.05) but not OS (HR 0.47; 95% CI 0.13-1.62, P = 0.23). In patients with a high risk of relapse (defined as a lymph node ratio >or=10%), adjuvant therapy appeared to improve OS, P = 0.04, but not DFS, P = 0.15. DISCUSSION: The use of adjuvant therapy for curatively resected small bowel adenocarcinoma was associated with an improvement in DFS. This finding strongly supports further investigation of adjuvant chemotherapy in this tumor type.

Duke Scholars

Published In

Acta Oncol

DOI

EISSN

1651-226X

Publication Date

May 2010

Volume

49

Issue

4

Start / End Page

474 / 479

Location

Sweden

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Kaplan-Meier Estimate
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Overman, M. J., Kopetz, S., Lin, E., Abbruzzese, J. L., & Wolff, R. A. (2010). Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine. Acta Oncol, 49(4), 474–479. https://doi.org/10.3109/02841860903490051
Overman, Michael J., Scott Kopetz, E. Lin, James L. Abbruzzese, and Robert A. Wolff. “Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine.Acta Oncol 49, no. 4 (May 2010): 474–79. https://doi.org/10.3109/02841860903490051.
Overman MJ, Kopetz S, Lin E, Abbruzzese JL, Wolff RA. Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine. Acta Oncol. 2010 May;49(4):474–9.
Overman, Michael J., et al. “Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine.Acta Oncol, vol. 49, no. 4, May 2010, pp. 474–79. Pubmed, doi:10.3109/02841860903490051.
Overman MJ, Kopetz S, Lin E, Abbruzzese JL, Wolff RA. Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine. Acta Oncol. 2010 May;49(4):474–479.

Published In

Acta Oncol

DOI

EISSN

1651-226X

Publication Date

May 2010

Volume

49

Issue

4

Start / End Page

474 / 479

Location

Sweden

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Kaplan-Meier Estimate