Small intestine cancer surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2] Parminder Dhingra, M.D. [3]

Overview

Curative surgery is the primary modality for treating small intestine cancers, in combination with chemotherapy and radiotherapy.

Surgery

Indications

  • Surgery is usually reserved for patients with resectable tumors.[1]
  • Tumors of jejunum and ileum.
  • For incurable tumor palliative surgery is another option.

Contraindications

  • Primary treatment for cancer of the small intestine is curative surgical resection.[2][3]
  • For non-metastatic disease curative surgery gives good results, when done in a tertiary care center.[4]
  • Adenocarcinoma of duodenum has a comparitive low 5-year disease free survival rate after surgery.[4]
  • Although surgical resection of small intestinal cancer plays an important role in the treatment, 5 yr survival rate is low even after surgery.[5]
  • Small intestine resection: In this operation, surgeon removes the piece of intestine that has the tumor and some of the normal tissue on each side of the tumor.
  • Palliative operation: If small intestine cancer has spread too far in the abdomen, the surgeon will do a palliative operation.
  • The goal of plaiative resection is to decrease symptoms such as abdominal pain and abdominal distension.

Chemotherapy

  • The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.
  • Some general chemotherapy drugs used include: 5-fluorouracil (5FU), leucovorin, oxaliplatin, and irinotecan.
  • Role of adjuvant chemotherapy for small intestinal cancer is not established yet.[6]
  • When curative resection is not possible, palliative surgery and chemotherapy are next options.[2]

Radiation therapy

  • Radiotherapy is used as an adjunct therapy in the treatment of intestinal cancer.
  • This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.

References

  1. "Adenocarcinoma of the small bowel - Surgical Treatment - NCBI Bookshelf".
  2. 2.0 2.1 Higashi D, Ishibashi Y, Tamura T, Nii K, Egawa Y, Koga M, Tomiyasu T, Harimura T, Tanaka R, Futatsuki R, Noda S, Futami K, Maekawa T, Takaki Y, Hirai F, Matsui T (August 2010). "Clinical features of and chemotherapy for cancer of the small intestine". Anticancer Res. 30 (8): 3193–7. PMID 20871040.
  3. Talamonti MS, Goetz LH, Rao S, Joehl RJ (May 2002). "Primary cancers of the small bowel: analysis of prognostic factors and results of surgical management". Arch Surg. 137 (5): 564–70, discussion 570–1. PMID 11982470.
  4. 4.0 4.1 Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (August 2004). "Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients". Cancer. 101 (3): 518–26. doi:10.1002/cncr.20404. PMID 15274064.
  5. Coco C, Rizzo G, Manno A, Mattana C, Verbo A (April 2010). "Surgical treatment of small bowel neoplasms". Eur Rev Med Pharmacol Sci. 14 (4): 327–33. PMID 20496543.
  6. Overman MJ, Kopetz S, Lin E, Abbruzzese JL, Wolff RA (May 2010). "Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine". Acta Oncol. 49 (4): 474–9. doi:10.3109/02841860903490051. PMID 20397775.

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