Primary Malignancies of the Small Bowel

Wilson, James M.; Melvin, David; Gray, George F.; Thorbjarnarson, Bjorn

doi:10.1097/00000658-197408000-00008

Cited by 183 publications

(52 citation statements)

References 30 publications

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“…93.4% of the patients with neuroendocrine tumors presented with flush and diarrhea – especially after consumption of red wine, otherwise symptoms were unspecific. A correct preoperative diagnose was made in 71.8% compared with 17–69% in other series [10, 11, 18, 20, 22, 23, 24, 25]. This figure may be misleading, since in our series many patients were seen at a later stage in their illness when they had obvious symptoms.…”

Section: Discussioncontrasting

confidence: 55%

“…The rate of elective/emergency surgery was 83.1%/16.9% compared to 55%/45% reported by Feil et al [42]. The rate of resection for cure of 93.6% compares favourable to the literature [18, 24, 25]. Postoperative mortality in all patients with malignant SBT was 6.4% – reported data in the literature are between 13 and 16% [22, 24, 43].…”

Section: Discussionmentioning

confidence: 75%

“…Regarding these categories, our data are comparable to those of Martin [13] and Broll et al [22], but there are substantial differences when considering each histological entity on its own. In the literature, adenocarcinomas are reported in more than 50% in the small intestine [18, 19, 25, 30, 35, 36] and in less than 30% by other authors [15, 16, 31, 33, 34, 37] (table 6). As known from the literature [38], adenocarcinomas are predominant in the duodenum (table 2).…”

Section: Discussionmentioning

confidence: 99%

“…According to the data of Peck et al [39], 93.3% of neuroendocrine tumors were localized in the ileum, while large series report neuroendocrine tumors as ileal lesions in 57–84.7% [19, 21]. Some series found neuroendocrine tumors to be the most common entity in small bowel neoplasms (34.2–45%) [9, 10, 17, 37], while in other series these tumors occurred within 30% in the small intestine [13, 15, 17, 18, 24, 25, 28]. In the gastrointestinal tract malignant lymphoma are usually localized in the stomach and only within 10% in the small bowel [40].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Resected Primary Small Bowel Tumors

Brücher¹,

Roder²,

Fink³

et al. 1998

Dig Surg

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We report a retrospective analysis of 71 patients, operated for primary small bowel tumors (SBT): 47 malignant (66.2%) and 24 benign (33.8%) tumors. Of the malignant tumors, adenocarcinomas predominated (38.3%), followed by neuroendocrine tumors (31.9%), Non-Hodgkin lymphomas (NHL) (12.8%), leiomyosarcomas (10.6%) and other rare entities (6.4%). Morbidity of surgical treatment was 16.9%, 30-day mortality 7%. The estimated 5-year survival rate in malignant lesions was 31.8%. Univariate analysis identified the presence of distant metastasis and the resection status (R status) as prognostic factors (p = 0.034 and p = 0.001). There was no influence of T, N status or grading on survival. A complete macroscopic and microscopic tumor resection has to be the aim of any curative surgical approach in patients with SBT.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Resected Primary Small Bowel Tumors

Brücher¹,

Roder²,

Fink³

et al. 1998

Dig Surg

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“…When symptoms and signs occur, they may be vague and nonspecific (e.g. intermittent acute abdominal pain in some instances due to intussusceptions; Wilson et al 1974) and misinterpreted as irritable bowel syndrome, asthma, perimenopausal neurotic or part of an anxiety, or food allergy response (Mooney 1985, Jacobs 2009). In bioactive tumors, variable symptoms may develop depending on the tumor cell of origin and the effects of the individual secretory agents (e.g.…”

Section: Protean Symptomatology: Late Diagnosis: Causes and Sequelaementioning

confidence: 99%

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

149

106

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) represent a heterogenous group of tumors arising from a variety of neuroendocrine cell types. The incidence and prevalence of GEPNENs have markedly increased over the last three decades. Symptoms are often absent in early disease, or vague and nonspecific even in advanced disease. Delayed diagnosis is thus common. Chromogranin A is the most commonly used biomarker but has limitations as does the proliferative marker Ki-67%, which is often used for tumor grading and determination of therapy. The development of a multidimensional prognostic nomogram may be valuable in predicting tumor behavior and guiding therapy but requires validation. Identification of NENs that express somatostatin receptors (SSTR) allows for SSTR scintigraphy and positron emission tomography imaging using novel radiolabeled compounds. Complete surgical resection of limited disease or endoscopic ablation of small lesions localized in stomach or rectum can provide cure; however, the majority of GEP-NENs are metastatic (most frequently the liver and/or mesenteric lymph nodes) at diagnosis. Selected patients with metastatic disease may benefit from advanced surgical techniques including hepatic resection or liver transplantation. Somatostatin analogs are effective for symptomatic treatment and exhibit some degree of antiproliferative activity in small intestinal NENs. There is a place for streptozotocin, temozolomide, and capecitabine in the management of pancreatic NENs, while new agents targeting either mTOR (everolimus) or angiogenic (sunitinib) pathways have shown efficacy in these lesions.

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