Updated 3 October 2007

Small Bowel Cancer Recurrence

The risk of recurrence after complete resection is high, 39% in the series from MDACC, with a median time to recurrence of 25 months (range, 3-99 months). Distant sites dominated followed by the development of abdominal carcinomatosis, abdominal wall recurrence and local recurrence.

Given that recurrence is almost always incurable, it is not recommended that patients be followed aggressively with routine diagnostic imaging or tumor markers. Patients should be followed using clinical parameters with appropriate investigations used for those patients with progressive symptoms and signs.

Second Malignancies

Various series have described an increase in other malignancies noted either prior to or subsequent to the diagnosis of small bowel adenocarcinoma. These may be in the large bowel or other organs such as prostate, lung or female genitalia.

It would be reasonable to recognize that patients with fully resected small bowel adenocarcinoma are at higher than average risk for a second malignancy and use this as a “filter” in evaluating any subsequent clinical manifestations particularly those related to the large bowel.