Clinical analysis of primary anaplastic carcinoma of the small intestine

Table 1 Clinicopathological data for reported cases of anaplastic carcinoma of the small intestine

Case	Author	Yr	Age	Gender	Chief complaint	Primary site	Tumor size (cm)	Tumor depth	Lymph node metastasis	Prognosis (mo)
1	Ikeda[22]	1974	62	F	Abdominal pain	Ileum	9	SE	Negative	Alive 12
2	Sasaki[23]	1988	37	M	Abdominal pain	Jejunum	7	SS	Positive	9
3	Robey-Cafferty[24]	1989	62	M	Cervical LN enlarge	Ileum	5	SI	ND	20
4			38	F	Fatigue	Jejunum	16	MP	Positive	8
5			48	F	Periumbilical mass	Jejunum	6	SI	Positive	2
6			65	M	Abdominal pain	Jejunum	5	SE	Positive	5
7			54	F	intestinal obstruction	Ileum	4.5	MP	Negative	Alive 12
8			35	F	Abdominal pain	Jejunum	7.5	ND	Negative	36
9	Ikeguchi[25]	1993	63	M	Abdominal pain	Ileum	4	SS	Negative	Alive 36
10	Amano[26]	1998	81	M	Abdominal pain	Jejunum	8.5	SE	Positive	1
11	Agrawal[27]	1999	53	M	melena	Ileum	13	SI	Positive	2
12	Nakamura[28]	2000	73	F	Vomiting	Ileum	3.5	SS	Negative	6
13	Kadoya[29]	2003	57	M	General fatigue	Ileum	21	SE	Positive	2
14	Sato[30]	2003	46	M	Back pain	Jejunum	9	SE	ND	4
15	Usuda[31]	2007	84	M	Fever of unknown origin	Jejunum	8	SE	Positive	1.5
16	Shiraishi[32]	2007	48	M	Abdominal pain	Jejunum	5	SE	Negative	Alive 8
17	Matsuoka[33]	2008	56	M	Abdominal pain	Jejunum	10	SS	Positive	1
18	Our case	2008	65	F	Anemia	Ileum	6	SS	Negative	Alive 8

MP: Muscularis propria layer; SS: Subserosal layer; SE: Penetration of serosa; SI: Invasion of adjacent structures; ND: Not described.

Table 2 Clinical characteristics after surgical resection of anaplastic carcinoma of the small intestine (mean ± SD)

Characteristics	No. of patients	3 yr survival rate (%)	Median survival in months	P value
Overall	17	10.8	5.0 ± 1.4
Age (yr)
< 65	13	15	9.0 ± 4.2	0.03
> 65	5	0	5.0 ± 1.6
Gender
Male	11	12.1	4.0 ± 1.5	0.38
Female	7	0	8.0 ± 2.6
Tumor depth
T2 (MP)	2	66.7	26.7 ± 7.6	0.21
T3 (SS)	5	0	6.0 ± 1.5
T4 (SE, SI)	10	0	2.0 ± 1.0
Tumor location
Jejunum	10	0	4.0 ± 2.4	0.17
Ileum	8	25	6.0 ± 7.0
Tumor size (cm)
< 7	8	28.6	20.0 ± 10.9
> 7	10	0	2.0 ± 1.3	0.13
LN metastasis
Negative	7	41.7	36.0 ± 21.9	0.0009
Positive	9	0	2.0 ± 0.3

MP: Muscularis propria layer; SS: Subserosal layer; SE: Penetration of serosa; SI: Invasion of adjacent structures.

Table 3 Relative risk with regard to survival rate according to the Cox proportional hazards model

Variable	Odds ratio (95% CI)	P value
Lymph node metastasis
Negative	13.7 (1.6-114.1)	0.016
Positive
Age (yr)
< 65	2.9 (0.7-11.8)	0.145
> 65

Table 4 Survival rates of patients with adenocarcinoma of the small intestine according to pathological differentiation

Author	Differentiation	No. of patients	Survival rate (%)		Significance
			5 yr	10 yr
Miles[7]	Well differentiated	13	15	8	0.18
	Undifferentiated	5	60	33
Veyrieres[10]	Well differentiated	51	>56	43	0.08
	Undifferentiated	6	40	0
Dabaja[11]	Well differentiated	>92	25		0.45
	Undifferentiated	57	24
Wu[13]	Well differentiated	33	88.7 ± 18.881		0.26
	Undifferentiated	10	13.3 ± 3.961
Robey-Cafferty[24]	Well differentiated	29	25		0.24
	Undifferentiated	6	0

¹Mean survival time (months ± SD).