Diagnostics and treatment of small intestine tumors in our own experience

Abstract

Introduction. Small intestine cancers are a difficult oncological problem. Lack of specific symptoms and difficulties with accessing the location even for advanced diagnostic techniques delay the diagnosis and implementation of appropriate treatment.

Aim. Analysis of incidence, clinical symptoms, diagnostic methods and results of treatment of small intestine tumors in the material of the Maria Skłodowska-Curie Institute — Oncology Center (MSCI) in Warsaw.

Material and method. A retrospective analysis of 54 patients undergoing surgery for small intestine tumor in the years 2006–2015. The evaluated group consisted of 26 (48%) males, 28 (52%) females, median age was 63.5 ± 13.5 years (23–86).

Results. In the study group 18 (33%) cases of sarcomas were found, including 16 (30%) cases of GIST. The remaining cases were diagnosed as: adenocarcinoma — 13 patients (24%), neuroendocrine tumor (NET) — 8 (15%), malignant melanoma — 6 (11%), lymphoma — 3 (6%) and benign tumors — 6 (11%). Symptoms included gastrointestinal bleeding (55.5%), abdominal pain (48%), weight loss (31.5%), nausea (30%), vomiting (24%), flatulence (24%), inte­stinal passage disturbances (15%). In 70% of patients anemia was diagnosed, which in 33% required an average of 4.5 packed red blood cells (PRBC) units (range 1–100) to be transfused before treatment. The test that led to diagnosis was in 26 (48%) cases computed tomography, in 8 (15%) cases capsule endoscopy and in 5 (9%) cases double-balloon enteroscopy. Partial resection of the small intestine with regional lymph nodes was performed in 38 patients (70%), local excision in 5 (9%) patients and anastomosis gastric pass in 4 (7%) patients. So far, 17 (31%) deaths have been reported in this group of patients. 5-year survival was 93.8% for sarcomas, 53.9% for SIC, 66.7% for GEP-NET.

Conclusions. Partial resection of the small intestine remains the basic method of radical surgical treatment. Both diagnostics and treatment should be carried out in reference centers.