Small Bowel Tumors : Clinical Presentation, Prognosis, and Outcome in 33 Patients in a Tertiary Care Center

Abstract EN

Introduction.

Small bowel cancers are rare.

Accumulation of data regarding their clinical presentation, pathologic features, prognostic factors, treatment modalities, and outcome is difficult.

Methods.

This is a retrospective study of the medical records of 33 patients with small bowel cancers treated at the American University of Beirut-Medical Center over a 20-year period.

Results.

The study included 25 males (76%) and 8 females (24%).

Median age at presentation was 56 years.

Most common symptoms were abdominal pain (66.7%) and weight loss (57.6%).

Thirteen patients presented with abdominal emergencies (39.3%).

Lymphoma was the most common malignant tumor (36.4%), followed by adenocarcinoma (33.3%), leiomyosarcoma (15.2%), gastrointestinal stromal tumors (12.1%), and neuroendocrine tumors (3.0%).

Tumors were located in the duodenum in 30% of patients, jejunum in 33%, and ileum in 36%.

Resectability rate was 72.7% and curative R0 resection was achieved in 54.1% (13/24) of patients.

5-year survival of the 33 patients was 24.2%.

Conclusion.

Small bowel cancers are difficult to diagnose because of the nonspecific symptoms.

Most patients present with advanced disease and have poor prognosis.

Adenocarcinoma and duodenal location have the worst 5-year survival in contrast to stromal tumors and those with ileal location which have the best survival.