Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile

• Published in: Gastroenterología y Hepatología (English Edition) 2024-05, Vol.47 (5), p.491-499
• Main Authors: Silva, Felipe, Bustamante, Miguel, Latorre, Gonzalo, Flandez, Jorge, Montero, Isabella, Dukes, Eitan, Gandara, Vicente, Robles, Camila, Uribe, Javier, Iglesias, Andrés, Bellolio, Felipe, Molina, María Elena, Migueles, Rodrigo, Urrejola, Gonzalo, Larach, Tomás, Besser, Nicolas, Sharp, Allan, Agüero, Carlos, Riquelme, Arnoldo, Vargas, José Ignacio, Candia, Roberto, Monrroy, Hugo, De Simone, Federico, Espino, Alberto
• Format: Article
• Language: English
• Subjects: Adenocarcinoma de intestino delgado; Enteroclisis; Enteroclysis; Gastrointestinal stromal tumors; Neuroendocrine tumors; Small bowel adenocarcinoma; Tumores del estroma gastrointestinal; Tumores neuroendocrinos
• ISSN: 2444-3824; 2444-3824
• DOI: 10.1016/j.gastre.2024.04.013

Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America. To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs. Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile. A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n=38), gastrointestinal stromal tumors (GIST) (21.8%, n=19), lymphoma (17.2%, n=15) and adenocarcinoma (AC) (11.5%, n=10). GIST was more frequent in duodenum (50%; n=12) and NET in the ileum (65.8%; n=25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC (p=0.035), as well as gastrointestinal bleeding in GIST (p=0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5-year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1–99.2), 82.2% (95%CI: 57.6–93.3), 40.0% (95%CI: 16.5–82.8) and 25.9% (95%CI: 4.5–55.7%), respectively. NET (HR 6.1; 95%CI: 2.1–17.2) and GIST (HR 24.4; 95%CI: 3.0–19.8) were independently associated with higher survival compared to AC, adjusted for age and sex. Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes. Los tumores del intestino delgado (TID) son infrecuentes y la información sobre ellos es escasa en Latinoamérica. Describir la epidemiología, características clínicas, métodos diagnósticos y supervivencia de los TID malignos. Estudio observacional retrospectivo de pacientes adultos con diagnóstico histopatológico de TID entre 2007-2021 en un hospital universitario de Chile. Se observaron 104 pacientes (51,9% hombres; edad media 57 años) con TID. El tipo histológico fue tumor neuroendocrino (TNE) (43,7%, n=38), tumor estromal gastrointestinal (GIST) (21,8%, n=19), linfoma (17,2%, n=15) y adenocarcinoma (AC) (11,5%, n=10). Los GIST fueron más frecuentes en el duodeno (50%; n=12) y los TNE en el íleon (65,8%; n=25). Hubo 17 casos de metástasis, más comúnmente de colon y melanoma. Las náuseas y los vómitos se observaro