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• W649610694 abstract "15588 Background: SIA is a rare disease (0.5/100.000/y). Limited data is available concerning the effect of palliative chemotherapy (pCT) in this disease. Resection of the primary tumour (PT) is not routinely performed if distant metastases (DM) are present. Methods: We evaluated the files of all pts with SIA who received at least one cycle of pCT. Pts were classified to have the initial PT or local recurrence (LR) surgically completely removed or not and whether they were offered a 2nd-line pCT in case of failure of 1st-line or not. Results: 44 pts, age 32–72, median (M) 60 were identified. The PT was: duodenum 24, jejunum 14, ileum 6. 21 pts were initially resected in curative intent and suffered a distant and/or local relapse after 1 - 104 months (mo), M 11 mo. When pCT was started for DM in 25 pts no local tumor was present whereas the remaining had PT/LR without DM (3) or both (16). Pts received a broad variety of fluoropyrimidine- based regimens in 1 to 4 lines (mainly colorectal-like protocols). Long lasting complete or partial remissions (12 - 136+ mo) in 1st- but also 2nd-line were observed in pts without PT/LR whereas the outcome was poor in general when local tumor was present. Survival was significantly longer in pts without PT/LR (M 40 mo) as compared to those with local tumor present (M 8 mo, p = 0.003 logrank). No obvious difference was observed whether the PT was resected in curative intent and DM occurred later or if palliative but complete resection of PT or LR was performed with DM present. 6 pts are still in remission. 18/38 pts with progressive disease on/after 1st-line received 2nd-line pCT (colorectal like regimens). If 2nd-line was offered survival was significant longer (M 26 mo vs 8 mo). Conclusions: In our series outcome of pts with metastatic SIA who have PT in situ and treated with pCT is comparable to that of other metastasized upper GI-malignancies. Our retrospective study supports the hypothesis that pCT in pt with metastatic SIA but no LT might be very effective. This means that even in palliative intent surgical local tumor control appears to be essential for a favourable outcome and should be considered. This is different to the situation in colorectal cancer. A prospective study of the issue is warranted. No significant financial relationships to disclose." @default.
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• W649610694 date "2008-05-20" @default.
• W649610694 modified "2023-10-18" @default.
• W649610694 title "Survival impact of primary tumor resection in metastatic small intestine adenocarcinoma (SIA): Retrospective analysis of 44 cases treated with palliative chemotherapy" @default.
• W649610694 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.15588" @default.
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