Tsung-Hui Hu, Tung-Lung Tsai,
Ming-Hong Tai*, and Hsueh-Wen
Chang**
Division of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung. *Department of Education and Research, Veterans General Hospital, Kaohsiung; and **Department of Biological Sciences, National Sun-Yat-Sen University, Taiwan, Republic of China.
| Background/Aims: Cancer of the small intestine
is a relatively rare type of cancer. There was little experience to deal
with primary adenocarcinoma of small intestine in Taiwan. This study was
designed to examine the clinical features, outcome and the relationship
between the pathologic stage and the survival rate in patients of
adenocarcinoma in small intestine
Materials and Methods: From 1987 to 1999, 23 patients with primary adenocarcinoma were treated at Kaohsiung Chang-Gung Memorial hospital. The clinical manifestation, age-sex incidence, and clinical outcome of these patients were studied. The tumor were graded into well, moderately and poorly differentiated groups. The extent of tumor invasion was staged by the TMN-classification. Statistical analysis was performed using the Fisher's Exact Test. Differences in survival rate were tested for significance with the log-rank test. Results: There were totally 23 cases, twelve tumors arose from duodenum, eight from the jejunum and three from the ileum. Most of the adenocarcinoma were moderately differentiated (10 cases), followed by well differentiated (3 cases), poorly differentiated (2 cases) and 8 unknown. At the time of diagnosis six cases were in stage 2, five in stage 3, and 11 cases in stage 4, with one unknown. Fourteen of the 23 patients received curative surgery, 7 patients received palliative surgery and 2 patients had supportive treatment only. Within a period of follow-up from 1 to 99 months, the overall survival rate was 26%. The prognosis correlate with the grade and stage of histology, but not with location of tumors Conclusion: Adenocarcinomas of small intestine were mostly found in the duodenum, with occasional presentations of anemia and abdominal pain. Capable of curative resection without nodal or extraserosal invasion and better histological grading and staging promise a good outcome. (J Intern Med Taiwan 1999;10:113-118)
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