ASO Author Reflections: Prognostication in Early- and Advanced-Stage Small Bowel Adenocarcinomas

Excerpt

Small bowel adenocarcinomas (SBAs) are rare and poorly investigated cancers. Therefore, for a long time, therapeutic approaches for these neoplasms have been mainly extrapolated from colorectal cancer studies. Compelling evidence that SBA is a distinct entity now exists, leading the National Comprehensive Cancer Network (NCCN) to recently publish clinical practice guidelines specific for SBA.1 Although clear data are still lacking, patients with stage II SBAs having high-risk features (pT4, positive resection margins, or a low number of lymph nodes harvested) may benefit from adjuvant chemotherapy. NCCN guidelines do not recommend adjuvant chemotherapy in stage II SBAs in case of mismatch repair deficiency (MMR-d), although the impact of this tumor phenotype on patient prognosis is still unclear.1,2 …