Abstract
Primary small intestine cancers are not frequent, accounting for <1 % of all adult neoplasms. Various histologic types are associated with small intestine cancer. The most common used to be adenocarcinoma; however, carcinoid tumors are showing an improved incidence and are the most common histologic type in some series. Adenocarcinomas are more frequent in the duodenum, while carcinoid tumors are more common in the ileum. Other histologic types are lymphomas and sarcomas. The symptoms are vague and non-specific. Less of an index of suspicious can cause a late the diagnosis. The stage at diagnosis is the most important prognostic factor. Radiologic and endoscopic exams can be performed to achieve a specimen sample and to stage the disease. Early tumors can be treated properly with surgical resection. Adjuvant treatment for adenocarcinoma has not been studied in large trials, but it is indicated in extrapolating colon data. The treatment for advanced adenocarcinoma of the small intestine has only been studied in a few large cohorts. Treatment for other histologic types is discussed in a separated chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Siegel RL, Miller KD, Jemal A (2015) Cancer statistics. CA Cancer J Clin 65(1):5–29
Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS (2009) Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 249(1):63–71
Westgaard A, Tafjord S, Farstad IN, Cvancarova M, Eide TJ, Mathisen O et al (2008) Pancreatobiliary versus intestinal histologic type of differentiation is an independent prognostic factor in resected periampullary adenocarcinoma. BMC Cancer 8:170
Chow WH, Linet MS, McLaughlin JK, Hsing AW, Chien HT, Blot WJ (1993) Risk factors for small intestine cancer. Cancer Causes Control 4(2):163–169
Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ et al (2007) Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry. Arch Surg 142(3):229–235
Haselkorn T, Whittemore AS, Lilienfeld DE (2005) Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control 16(7):781–787
Wheeler JM, Warren BF, Mortensen NJ, Kim HC, Biddolph SC, Elia G et al (2002) An insight into the genetic pathway of adenocarcinoma of the small intestine. Gut 50(2):218–223
Zhang MQ, Chen ZM, Wang HL (2006) Immunohistochemical investigation of tumorigenic pathways in small intestinal adenocarcinoma: a comparison with colorectal adenocarcinoma. Mod Pathol 19(4):573–580
Abrahams NA, Halverson A, Fazio VW, Rybicki LA, Goldblum JR (2002) Adenocarcinoma of the small bowel: a study of 37 cases with emphasis on histologic prognostic factors. Dis Colon Rectum 45(11):1496–1502
Giardiello FM, Brensinger JD, Tersmette AC, Goodman SN, Petersen GM, Booker SV et al (2000) Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 119(6):1447–1453
Jess T, Winther KV, Munkholm P, Langholz E, Binder V (2004) Intestinal and extra-intestinal cancer in Crohn’s disease: follow-up of a population-based cohort in Copenhagen County. Denmark Aliment Pharmacol Ther 19(3):287–293
Wu AH, Yu MC, Mack TM (1997) Smoking, alcohol use, dietary factors and risk of small intestinal adenocarcinoma. Int J Cancer 70(5):512–517
Ciresi DL, Scholten DJ (1995) The continuing clinical dilemma of primary tumors of the small intestine. Am Surg 61(8):698–702, discussion -3
Howe JR, Karnell LH, Menck HR, Scott-Conner C (1999) The American College of Surgeons Commission on Cancer and the American Cancer Society. Adenocarcinoma of the small bowel: review of the national cancer data base, 1985–1995. Cancer 86(12):2693–2706
Saha S, Hoda S, Godfrey R, Sutherland C, Raybon K (1989) Carcinoid tumors of the gastrointestinal tract: a 44-year experience. South Med J 82(12):1501–1505
Koch P, del Valle F, Berdel WE, Willich NA, Reers B, Hiddemann W et al (2001) Primary gastrointestinal non-Hodgkin’s lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 19(18):3861–3873
Maglinte DD, O’Connor K, Bessette J, Chernish SM, Kelvin FM (1991) The role of the physician in the late diagnosis of primary malignant tumors of the small intestine. Am J Gastroenterol 86(3):304–308
Zollinger RM (1986) Primary neoplasms of the small intestine. Am J Surg 151(6):654–658
Estrin HM, Farhi DC, Ament AA, Yang P (1987) Ileoscopic diagnosis of malignant lymphoma of the small bowel in acquired immunodeficiency syndrome. Gastrointest Endosc 33(5):390–391
Lewis BS, Eisen GM, Friedman S (2005) A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 37(10):960–965
Cobrin GM, Pittman RH, Lewis BS (2006) Increased diagnostic yield of small bowel tumors with capsule endoscopy. Cancer 107(1):22–27
Wiarda BM, Mensink PB, Heine DG, Stolk M, Dees J, Hazenberg H et al (2012) Small bowel Crohn’s disease: MR enteroclysis and capsule endoscopy compared to balloon-assisted enteroscopy. Abdom Imaging 37(3):397–403
Laurent F, Raynaud M, Biset JM, Boisserie-Lacroix M, Grelet P, Drouillard J (1991) Diagnosis and categorization of small bowel neoplasms: role of computed tomography. Gastrointest Radiol 16(2):115–119
Pilleul F, Penigaud M, Milot L, Saurin JC, Chayvialle JA, Valette PJ (2006) Possible small-bowel neoplasms: contrast-enhanced and water-enhanced multidetector CT enteroclysis. Radiology 241(3):796–801
Kalady MF, Clary BM, Clark LA, Gottfried M, Rohren EM, Coleman RE et al (2002) Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms. Ann Surg Oncol 9(8):799–806
Edge S, Byrd D, Compton C et al (eds) (2010) AJCC. Cancer staging manual, 7th edn. Springer, New York, 181 p
Frost DB, Mercado PD, Tyrell JS (1994) Small bowel cancer: a 30-year review. Ann Surg Oncol 1(4):290–295
DiSario JA, Burt RW, Vargas H, McWhorter WP (1994) Small bowel cancer: epidemiological and clinical characteristics from a population-based registry. Am J Gastroenterol 89(5):699–701
Bakaeen FG, Murr MM, Sarr MG, Thompson GB, Farnell MB, Nagorney DM et al (2000) What prognostic factors are important in duodenal adenocarcinoma? Arch Surg 135(6):635–641, discussion 41-2
Singhal N, Singhal D (2007) Adjuvant chemotherapy for small intestine adenocarcinoma. Cochrane Database Syst Rev 3:CD005202
Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (2004) Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer 101(3):518–526
Barnes G, Romero L, Hess KR, Curley SA (1994) Primary adenocarcinoma of the duodenum: management and survival in 67 patients. Ann Surg Oncol 1(1):73–78
Nicholl MB, Ahuja V, Conway WC, Vu VD, Sim MS, Singh G (2010) Small bowel adenocarcinoma: understaged and undertreated? Ann Surg Oncol 17(10):2728–2732
Overman MJ, Kopetz S, Lin E, Abbruzzese JL, Wolff RA (2010) Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine. Acta Oncol 49(4):474–479
Halfdanarson TR, McWilliams RR, Donohue JH, Quevedo JF (2010) A single-institution experience with 491 cases of small bowel adenocarcinoma. Am J Surg 199(6):797–803
Haan JC, Buffart TE, Eijk PP, van de Wiel MA, van Wieringen WN, Howdle PD et al (2012) Small bowel adenocarcinoma copy number profiles are more closely related to colorectal than to gastric cancers. Ann Oncol 23(2):367–374
André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C et al (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27(19):3109–3116
Overman MJ, Kopetz S, Wen S, Hoff PM, Fogelman D, Morris J et al (2008) Chemotherapy with 5-fluorouracil and a platinum compound improves outcomes in metastatic small bowel adenocarcinoma. Cancer 113(8):2038–2045
Overman MJ, Varadhachary GR, Kopetz S, Adinin R, Lin E, Morris JS et al (2009) Phase II study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater. J Clin Oncol 27(16):2598–2603
Nakayama N, Horimatsu T, Takagi S, Moriwaki T, Hirashima Y (2014) A phase II study of 5-FU/l-LV/oxaliplatin (mFOLFOX6) in patients with metastatic or unresectable small bowel adenocarcinoma. J Clin Oncol 32(suppl; abstr 3646)
Zaanan A, Costes L, Gauthier M, Malka D, Locher C, Mitry E et al (2010) Chemotherapy of advanced small-bowel adenocarcinoma: a multicenter AGEO study. Ann Oncol 21(9):1786–1793
Zaanan A, Gauthier M, Malka D, Locher C, Gornet JM, Thirot-Bidault A et al (2011) Second-line chemotherapy with fluorouracil, leucovorin, and irinotecan (FOLFIRI regimen) in patients with advanced small bowel adenocarcinoma after failure of first-line platinum-based chemotherapy: a multicenter AGEO study. Cancer 117(7):1422–1428
Sun Y, Shen P, Stewart JH, Russell GB, Levine EA (2013) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma. Am Surg 79(6):644–648
Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandalà M, Cervantes A et al (2013) Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi64–vi72
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Aguiar, P.N., Barreto, C.M.N., Forones, N.M., Tadokoro, H., de Mello, R.A. (2015). Small Intestine Cancer. In: de Mello, R., Tavares, Á., Mountzios, G. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-21683-6_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-21683-6_15
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-21682-9
Online ISBN: 978-3-319-21683-6
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)