Prognostic value of the TNM-classification for small bowel cancer.

Objective: To examine the relationship between the pathological stage and survival for adenocarcinoma of the small bowel.

Methods: The medical records of 99 patients with small bowel cancer, diagnosed between January 1984 and December 1993, were reviewed retrospectively. Lymphomas and carcinomas of the ampulla of Vater were excluded from this study. All operated patients with adenocarcinomas were staged by the TNM-classification using pathological and surgical reports.

Results: Sixty-four adenocarcinomas, 24 carcinoid tumours and 11 sarcomas were analysed. The cancer-specific 5-year survival rate for patients with adenocarcinoma, carcinoid tumours and sarcomas was 22%, 39% and 55%, respectively. Twenty-eight patients with adenocarcinoma underwent radical tumor resection: segmental resection in 20, pancreaticoduodenectomy in 7 and ileocoecal resection in one patient. In the remaining 34 patients "curative" resection was not feasible and none of them survived for more than 3 years. The 5-year survival rate of the curatively resected patients was 46%. Actuarial 3-year survival rate for stage I was 38%, 70% for stage II and 0% for stage III.

Conclusions: Our results demonstrate that survival is poor for patients with lymph node metastasis, despite apparently curative surgery.