Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment

Dig Liver Dis. 2014 Feb;46(2):97-104. doi: 10.1016/j.dld.2013.04.013. Epub 2013 Jun 21.

Abstract

Small bowel adenocarcinomas are rare tumours, but their incidence is increasing. Their most common primary location is the duodenum. The few studies that have collected data regarding small bowel adenocarcinoma are not homogeneous and are widely spread over time. Even though these tumours are most often sporadic, some predisposing diseases have been identified, among which Crohn's disease and genetic syndromes. Early diagnosis of small bowel adenocarcinoma remains difficult despite significant radiological and endoscopic progress. After surgical resection the main prognostic factor is node invasion; in this case, adjuvant chemotherapy can be expected to be beneficial, although this has not been established by randomised trials. For metastatic disease, platinum-based chemotherapy seems to be the most effective treatment. Targeted therapies have not yet been evaluated in this type of cancer.

Keywords: Carcinogenesis; Chemotherapy; Lynch syndrome; Prognostic factor; Rare tumour; Small intestine adenocarcinoma.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / therapy
  • Adenomatous Polyposis Coli / genetics
  • Alcohol Drinking / epidemiology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Celiac Disease / epidemiology
  • Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
  • Crohn Disease / epidemiology
  • Digestive System Surgical Procedures
  • Duodenal Neoplasms / diagnosis
  • Duodenal Neoplasms / epidemiology*
  • Duodenal Neoplasms / therapy
  • Genetic Predisposition to Disease
  • Humans
  • Ileal Neoplasms / diagnosis
  • Ileal Neoplasms / epidemiology*
  • Ileal Neoplasms / therapy
  • Jejunal Neoplasms / diagnosis
  • Jejunal Neoplasms / epidemiology*
  • Jejunal Neoplasms / therapy
  • Peutz-Jeghers Syndrome / genetics
  • Prognosis
  • Risk Factors
  • Smoking / epidemiology