Study Supports Adjuvant Chemo for Resected Stage 3 Small Bowel Cancer
Adjuvant chemotherapy may be effective for patients with resected stage 3 small bowel adenocarcinoma and select patients with earlier stage disease, a study published online ahead of print in the journal Cancer has shown.1
Because the role of adjuvant chemotherapy in the treatment of small bowel adenocarcinoma is poorly defined, and previous analysis have failed to demonstrate a survival advantage due to small sample sizes, researchers at the University of Pennsylvania in Philadelphia sought to conduct a propensity score-matched analysis to evaluate this treatment approach.
For the study, researchers identified 4746 patients with resected stage 1 to 3 small bowel adenocarcinoma, of which 1674 had received adjuvant chemotherapy and 3072 had underwent surgery alone between 1998 and 2011, from the National Cancer Data Base.
Results showed that patients who had received surgery alone had an increased risk of death compared with those who had received adjuvant chemotherapy (HR, 1.36; 95% CI: 1.24-1.50; P<.001).
Researchers found that there was a nonsignificant trend toward improved survival with adjuvant chemotherapy in patients with stage 1 disease (P=.226) and stage 2 disease (P=.185), including those with T4 disease or a positive resection margin.
In contrast, the study demonstrated a superior median overall survival for patients with stage 3 adenocarcinoma who were receiving adjuvant chemotherapy vs surgery alone (42.4 months vs 26.1 months; P<.001).
1. Ecker BL, McMillan MT, Datta J, et al. Efficacy of adjuvant chemotherapy for small bowel adenocarcinoma: A propensity score–matched analysis [published online ahead of print December 30, 2015]. Cancer. doi:10.1002/cncr.29840.