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Epidemiologic and Clinical Characteristics of 1260 Cases From the Connecticut Tumor Registry

Ioannis Hatzaras, MD; J. Alexander Palesty, MD; Farshad Abir, MD; Paul Sullivan, BA; Robert A. Kozol, MD; Stanley J. Dudrick, MD; Walter E. Longo, MD

Arch Surg. 2007;142(3):229-235.

Objective  To examine the epidemiology and clinical characteristics of small-bowel cancer.

Design  Patients with small-bowel tumors reported between 1980 and 2000, studied retrospectively.

Setting  Data from the Connecticut Tumor Registry.

Patients  One thousand sixty small-bowel cancer cases: 628 men (49.84%) and 632 women (50.16%). Mean age at presentation was 65.2 years.

Results  The most common location of small-bowel tumors was the ileum (374 cases; 29.7%), followed by the duodenum (320 cases; 25.4%) and the jejunum (193 cases; 15.3%). In 367 patient cases (29.1%: 192 men [30.6%] and 175 women [27.7%]), a prior or subsequent tumor of the gastrointestinal tract was reported. The most prevalent histologic type was carcinoid (417 cases; 33%), followed by adenocarcinoma (341 cases; 27%) and lymphoma (205 cases; 16.3%). The patient population was predominantly white (1159 patients; 92%), followed by African American patients (91 patients; 7.2%). Stratification by consecutive 7-year intervals showed the following: from 1980 to 1986, there were 10.5 cases per 100 000 individuals; from 1987 to 1993, there were 13.05 cases per 100 000 individuals; and from 1994 to 2000, there were 14.86 cases per 100 000 individuals. Men comprised 44.8% of cases from 1980 to 1986, 50.2% of cases from 1987 to 1993, and 53.3% of cases from 1994 to 2000. African American patients accounted for 7.5% of all cases from 1980 to 1986, 5.8% from 1986 to 1993, and 8.2% of cases from 1994 to 2000. In 1106 patients (87.7%), the primary therapy was surgical, including intestinal bypass, radical excision, excisional biopsy, and subtotal or total excision.

Conclusions  The incidence of small-bowel tumors in Connecticut has increased during the past 2 decades, with the highest rate of increase in men. Carcinoid tumors are the most common small intestinal cancers identified histologically, followed by adenocarcinomas. The former seems to be more frequently seen in the ileum, the latter in the duodenum. Surgery is the treatment of choice for the cure or palliation of small-bowel cancers.

Author Affiliations: Department of Surgery, Yale University School of Medicine, New Haven, Conn (Drs Hatzaras, Abir, Dudrick, and Longo); State of Connecticut Department of Public Health, Connecticut Tumor Registry, Hartford (Mr Sullivan); Department of Surgery, University of Connecticut School of Medicine, Farmington (Drs Palesty and Kozol); and Department of Surgery, Saint Mary's Hospital/Yale Affiliate, Waterbury, Conn (Drs Palesty and Dudrick).

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