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Dig Liver Dis. 2018 Jan;50(1):15-19. doi: 10.1016/j.dld.2017.09.123. Epub 2017 Oct 6.

Small bowel adenocarcinoma: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO).

Author information

1
Centre Hospitalier Meaux, Meaux, France. Electronic address: c-locher@ch-meaux.fr.
2
Centre Hospitalier Meaux, Meaux, France.
3
APHP Saint Antoine, Paris Cedex 12, France.
4
CHU Purpan, Toulouse Cedex 9, France.
5
UNICANCER Val d'Aurelle, Montpellier Cedex 5, France.
6
APHP HEGP, Paris Cedex 15, France.
7
APHP Saint Louis, Paris, France.
8
UNICANCER Bergonié, Bordeaux Cedex, France.
9
CHU Mitterand, Dijon Cedex, France.
10
CHU Charles Nicolle, Rouen Cedex, France.
11
APHP Lariboisière, Paris Cedex 10, France.
12
Institut Hospitalier Franco-Britannique, Levallois-Perret, France.
13
CHU de Reims, Reims Cedex, France.

Abstract

BACKGROUND:

This document is a summary of the French intergroup guidelines regarding the management of small bowel adenocarcinoma published in October 2016.

METHOD:

This collaborative work, co-directed by most French Medical Societies, summarizes clinical practice recommendations (guidelines) on the management of small bowel adenocarcinoma. Given the lack of specific data in the literature, all references are given by analogy with colon cancer. The classification used is the AJCC (American Joint Committee on Cancer) pTNM classification (7th edition 2009).

RESULTS:

Small bowel adenocarcinoma has a poor prognosis; less than 30% of patients survive for 5 years after the (first) diagnosis (5-year survival of less than 30%). Due to the rarity of the disease and the retrospective data, most recommendations are based on expert agreement. The initial evaluation is based on chest-abdomen-pelvis CT scan, CEA assay, GI endoscopy and colonoscopy in order detect lesions associated with a predisposing disease. Surgical treatment is currently the only curative option for stage I and II. Adjuvant chemotherapy can be discussed for Stage III and Stage II with T4 (expert agreement). With regard to metastatic tumors, treatment with fluoropyrimidine combined with platinum salts should be considered (expert agreement).

CONCLUSION:

Few specific data exist in the literature on this type of tumor; most of the recommendations come from expert agreements or by analogy with colon cancer. Thus, each case must be discussed within a multidisciplinary team.

KEYWORDS:

Guidelines; National recommendations; Small bowel adenocarcinoma

PMID:
29174568
DOI:
10.1016/j.dld.2017.09.123
[Indexed for MEDLINE]

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