Small intestine cancer natural history, complications, and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2], Parminder Dhingra, M.D. [3]

Overview

Clinical features and natural history of small intestinal tumors have not been clearly studied, as its a rare condition. Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor. Small intestine adenocarcinoma is associated with a 5 year survival rate of 20%.

Natural History

  • Clinical features and natural history of small intestinal tumors have not been clearly studied, as its a rare condition.[1]
  • Although, primary adenocarcinoma is the most common type of small intestine cancer, there is no known pattern of its natural history.[2]
  • Natural history of carcinoid tumors depends on several factors:[3]
    • Size
    • Site of origin
    • Growth pattern
    • Hormone dependence
    • Neuropeptides and amines expressed by a carcinoid
    • Amount of biologically active neuro-hormones secreted

Complications

  • Small intestine cancer are diagnosed in advance stage due to absence of specific symptoms and suspicion.
  • Most complications appear after the resection of the tumor post-operatively.[4]
  • When tumor grow larger to obstruct the lumen of intestine symptoms of constipation and obstruction appear.
  • Tumor may invade vessels of intestine and may lead to melena and hemorrhage.

Prognosis

References

  1. Higashi D, Ishibashi Y, Tamura T, Nii K, Egawa Y, Koga M, Tomiyasu T, Harimura T, Tanaka R, Futatsuki R, Noda S, Futami K, Maekawa T, Takaki Y, Hirai F, Matsui T (August 2010). "Clinical features of and chemotherapy for cancer of the small intestine". Anticancer Res. 30 (8): 3193–7. PMID 20871040.
  2. Hong SH, Koh YH, Rho SY, Byun JH, Oh ST, Im KW, Kim EK, Chang SK (January 2009). "Primary adenocarcinoma of the small intestine: presentation, prognostic factors and clinical outcome". Jpn. J. Clin. Oncol. 39 (1): 54–61. doi:10.1093/jjco/hyn122. PMID 18997182.
  3. Creutzfeldt W (1994). "Historical background and natural history of carcinoids". Digestion. 55 Suppl 3: 3–10. doi:10.1159/000201195. PMID 7698535.
  4. Wang XJ, Chi P, Lin HM, Lu XR, Huang Y, Xu ZB, Huang SH, Sun YW, Ye DX (2018). "Risk Factors for Early Postoperative Small Bowel Obstruction after Elective Colon Cancer Surgery: An Observational Study of 1,244 Consecutive Patients". Dig Surg. 35 (1): 49–54. doi:10.1159/000468155. PMID 28486220.
  5. Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (August 2004). "Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients". Cancer. 101 (3): 518–26. doi:10.1002/cncr.20404. PMID 15274064.

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