イタバシ　ミチオ   Itabashi Michio   板橋　道朗    所属   医学部 医学科（東京女子医科大学病院）    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan
掲載誌名	正式名：Journal of gastroenterology 略　 称：J Gastroenterol ISSNコード：14355922/09441174
掲載区分	国内
巻・号・頁	59(5),pp.376-388
著者・共著者	YAMASHITA Ken, OKA Shiro, YAMADA Takeshi, MITSUI Keigo, YAMAMOTO Hironori, TAKAHASHI Keiichi, SHIOMI Akio, HOTTA Kinichi, TAKEUCHI Yoji, KUWAI Toshio, ISHIDA Fumio, KUDA Shin-Ei, SAITO Shoichi, UENO Masashi, SUNAMI Eiji, YAMANO Tomoki, ITABASHI Michio, OHTSUKA Kazuo, KINUGASA Yusuke, MATSUMOTO Takayuki, SUGAI Tamotsu, URAOKA Toshio, KURAHARA Koichi, YAMAGUCHI Shigeki, KATO Tomohiro, OKAJIMA Masazumi, KASHIDA Hiroshi, AKAGI Yoshito, IKEMATSU Hiroaki, ITO Masaaki, ESAKI Motohiro, KAWAI Masaya, YAO Takashi, HAMADA Madoka, HORIMATSU Takahiro, KODA Keiji, FUKAI Yasumori, KOMORI Koji, SAITOH Yusuke, KANEMITSU Yukihide, TAKAMARU Hiroyuki, YAMADA Kazutaka, NOZAWA Hiroaki, TAKAYAMA Tetsuji, TAGASHI Kazutomo, SHINTO Eiji, TORISU Takehiro, TOYOSHIMA Akira, OHMIYA Naoki, KATO Takeshi, OTSUJI Eigo, NAGATA Shinji, HASHIGUCHI Yojiro, SUGIHARA Kenichi, AJIOKA Yoichi, TANAKA Shinji
発行年月	2024/05
概要	BACKGROUND:The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan.METHODS:We analyzed 354 patients with 358 PSBAs, between January 2008 and December 2017, at 44 institutions affiliated with the Japanese Society for Cancer of the Colon and Rectum.RESULTS:The median age was 67 years (218 males, 61.6%). The average tumor size was 49.9 (7-100) mm. PSBA sites consisted of jejunum (66.2%) and ileum (30.4%). A total of 219 patients (61.9%) underwent diagnostic small bowel endoscopy, including single-balloon endoscopy, double-balloon endoscopy, and capsule endoscopy before treatment. Nineteen patients (5.4%) had Lynch syndrome, and 272 patients (76.8%) had symptoms at the initial diagnosis. The rates for stages 0, I, II, III, and IV were 5.4%, 2.5%, 27.1%, 26.0%, and 35.6%, respectively. The 5-year overall survival rates at each stage were 92.3%, 60.0%, 75.9%, 61.4%, and 25.5%, respectively, and the 5-year disease-specific survival (DSS) rates were 100%, 75.0%, 84.1%, 59.3%, and 25.6%, respectively. Patients with the PSBA located in the jejunum, with symptoms at the initial diagnosis or advanced clinical stage had a worse prognosis. However, multivariate analysis using Cox-hazard model revealed that clinical stage was the only significant predictor of DSS for patients with PSBA.CONCLUSIONS:Of the patients with PSBA, 76.8% had symptoms at the initial diagnosis, which were often detected at an advanced stage. Detection during the early stages of PSBA is important to ensure a good prognosis.
DOI	10.1007/s00535-024-02081-3
PMID	38411920