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      Incidence and management of primary malignant small bowel cancers: a well-defined French population study.

      The American Journal of Gastroenterology
      Adenocarcinoma, epidemiology, pathology, therapy, Age Distribution, Aged, Endocrine Gland Neoplasms, Female, France, Humans, Incidence, Intestinal Neoplasms, Intestine, Small, Lymphoma, Male, Middle Aged, Sarcoma, Sex Distribution, Survival Rate

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          Abstract

          Few data are available from population-based statistics on small bowel cancers. The aim of this study was to report on their incidence and management. Data were obtained from the population-based Digestive Cancer Registry of Burgundy over a 26-yr period. Incidence rates were calculated by gender, age group, histological type, and 5-yr period. Treatment and stage at diagnosis were investigated. Prognosis was determined using crude and relative survival rates. A multivariate relative survival analysis was performed. Age-standardized incidence rates were 1.2/100,000 inhabitants for men and 0.8/100,000 inhabitants for women. The mean 5-yr variation in incidence were, respectively, +46.7% (P < 0.01) and + 53.2% (P < 0.05). There were four main histological types: adenocarcinoma (40.4%), malignant endocrine tumors (30.5%), lymphoma (20.1%), and sarcoma (9.0%). Resection for cure was performed in 56.6% of the cases. Cancer was not extending beyond the organ in 33.2% of the cases, was associated with lymph node metastasis in 32.1%, and with distant metastasis or unresectability in 34.7%. The 5-yr relative survival rate was 37.4%. It varied between 56.8% for endocrine tumors and 17.8% for sarcoma. In the multivariate analysis, age, histology, and stage at diagnosis significantly influenced the prognosis. Small bowel cancers represent a heterogeneous group of rare tumors. Prognosis at a population level is worse than in hospital series. In the short term, new therapeutic possibilities represent the best way to improve prognosis.

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