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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

5950 - The role of adjuvant therapy in resectable SBA: a different clinicians attitude with a relevant impact on outcome.

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Cytotoxic Therapy

Tumour Site

Gastrointestinal Cancers

Presenters

Giulia Orsi

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

G. Orsi1, K. Andrikou1, F. Bergamo2, F. Nappo3, C. Manai2, A. Passardi4, M. Puzzoni5, S. Vallarelli6, M. Libertini7, M.L. Riggi1, G. Pugliese8, A. Zaniboni7, M. Schirripa9, L. Procaccio3, N. Silvestris10, M. Scartozzi5, A. Casadei Gardini4, V. Zagonel2, S. Cascinu8

Author affiliations

  • 1 Department Of Oncology/hematology, University Of Modena And Reggio Emilia, Modena Cancer Center,, 41124 - modena/IT
  • 2 Medical Oncology Unit 1, Department Of Clinical And Experimental Oncology, Veneto Institute of Oncology IOV - IRCCS, Padula/IT
  • 3 Medical Oncology 1, Department Of Clinical And Experimental Oncology, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 4 Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 - Meldola/IT
  • 5 University Of Cagliari, Department of Medical Oncology, 09121 - cagliari/IT
  • 6 Istituto Tumori "giovanni Paolo Ii", Medical Oncology Unit, National Cancer Research Centre, bari/IT
  • 7 Fondazione Poliambulanza, Oncology Department, 25121 - brescia/IT
  • 8 Oncologia, Azienda Ospedaliero - Universitaria Policlinico di Modena, 41100 - Modena/IT
  • 9 Medical Oncology, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 10 Istituto Tumori "giovanni Paolo Ii", Medical Oncology Unit and Scientific Direction, National Cancer Research Centre, 80100 - bari/IT
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Resources

Abstract 5950

Background

Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1-2% of gastrointestinal tumours. We evaluated the clinico-pathological characteristics, outcomes and prognostic factors of patients who underwent surgery for SBA.

Methods

We retrospectively analysed the features and outcome parameters of 54 SBA patients from 6 italian institutions between 2005 and 2017.

Results

The primary tumour was in the duodenum, jejunum and ileum in 30 (55.6%), 18 (33.3%) and 6 (11.1%) patients, respectively. Among the 54 patients studied, adjuvant chemotherapy were performed in 35.2 % of patients with stage II and in 27.8 % of patients with stage III. Relapse rates were higher for chemonaive patients compared to treated patients (50% vs 23.5%). Median overall (OS) and progression-free survival (PFS) were 26.98 and 19.78 months, respectively. Duodenal adenocarcinoma (p = 0.022), lymph node metastases (p = 0.00269), long-term treatment with metformin (p = 0.0095), no adjuvant treatment (p = 0.0006) and PLR >0,1766 (p = 0,0137) were associated with poor overall survival outcomes. The factors associated with PFS were patients with older age (>75 years) (p = 0.04) and T4 according to TNM system (p = 0.02).

Conclusions

The lack of well-defined guidelines for treatment of SBA justifies the heterogeneity of therapeutic choices resulting in negative impact on patient outcomes. Thus, there is an urgent need for prognostic and predictive biomarkers to guide therapy decisions for these patients. Our results suggest that the site, lymph node metastases, metformin and PLR >0,1766 could be novel prognostic markers for SBA patients who undergo curative surgery. However, prospective studies are necessary to confirm the role of these factors and identify new potential biomarkers of treatment efficacy, that could improve the selection of the right treatment for the right patient.

Clinical trial identification

Legal entity responsible for the study

Modena University Hospital.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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