gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Small bowel adenocarcinoma: cytotoxic chemotherapy for metastatic disease seemes to be more effective than commonly thought - Retrospective analysis of 39 cases

Meeting Abstract

  • corresponding author presenting/speaker Albrecht Kretzschmar - HELIOS-Klinikum, Charité, Campus Berlin-Buch, Deutschland
  • Ralf-Dieter Hofheinz - Universitätsklinikum, Mannheim
  • Michael Stahl - Kliniken Essen-Mitte, Essen
  • Peter C. Thuss-Patience - Charité, Campus Virchow-Klinikum, Berlin
  • Daniel Pink - HELIOS-Klinikum, Charité, Campus Berlin-Buch
  • Christof Burkart - Universitätsklinikum, Tübingen
  • Alicja Mrozek - HELIOS-Klinikum, Charité, Campus Berlin-Buch
  • Kai Klima - HELIOS-Klinikum, Charité, Campus Berlin-Buch
  • Peter Reichardt - HELIOS-Klinikum, Charité, Campus Berlin-Buch
  • Jörg Thomas Hartmann - Universitätsklinikum, Tübingen

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP176

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Kretzschmar et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Small bowel Adenocarcinoma (SBA) is a rare disease with probably less than 400 new cases diagnosed per year in Germany. Only limited data is available concerning the effect of palliative chemotherapy (CT) in this disease.

Methods: We retrospectively evaluated the files of all patients (Pt) in 8 centers who received at least one cycle of palliative CT (1988 - 2005). Pt were classified to have the primary (PRI) or local recurrence (LR) surgically removed or not and whether they were offered a 2nd-line CT in case of failure or not.

Results: 39 Pt, age 36-72, median (M) 60 were identified; PRI: duodenum 20, jejunum 13, ileum 6. 20 Pt were initially curatively resected and had a time to distant and /or local failure of M 11 months (mo) (1-104). 25 Pt had no PRI / LR when CT was started for distant metastases (DM) whereas the remaining had local tumor without DM(3) or both (11). Pt received a broad variety of fluoropyrimidine-based regimens in 1 to 4 lines (mainly colorectal-like or gastric-like protocols). Long lasting complete or partial remissions (12 - 111+ mo) were observed in Pt without local tumour or peritoneal carcinosis (PER) in 1st- but also 2nd- and 3rd-line (longest CR 111+ mo in pt with histological confirmed DM; objective responses 10/39 in 1st-line). Survival was significant longer (M 40 mo vs. 8 mo, p = 0.003) in Pt without local tumor. It had no impact on survival, whether the primary was removed initially in curative intent or in palliative intent with DM present. 6 pt are still in remission following 1st-line chemotherapy. 18/33 progressing Pt received 2nd-line. If 2nd-line was offered survival was significant longer (M 26 mo vs 8 mo).

Conclusions: Although this is a retrospective study the effect of CT in pt with SBA and distant metastasis offered 1st- and subsequent lines of CT is impressive as compared to other types of upper GI cancer. But outcome of Pt in our series who had local tumor (PRI or LR) was poor. So even in palliative intent surgical local tumor control appears to be essential for a favourable outcome.