Small Bowel Adenocarcinoma

Gastroenterol Clin North Am. 2016 Sep;45(3):447-57. doi: 10.1016/j.gtc.2016.04.004.


Small bowel adenocarcinomas (SBAs) are rare tumors, but their incidence is increasing. The most common primary location is the duodenum. Even though SBAs are more often sporadic, some diseases are risk factors. Early diagnosis of small bowel adenocarcinoma remains difficult, despite significant radiologic and endoscopic progress. After R0 surgical resection, the main prognostic factor is lymph node invasion. An international randomized trial (BALLAD [Benefit of Adjuvant Chemotherapy For Small Bowel Adenocarcinoma] study) will evaluate the benefit of adjuvant chemotherapy. For metastatic disease, retrospectives studies suggest that platinum-based chemotherapy is the most effective treatment. Phase II studies are ongoing to evaluate targeted therapy in metastatic SBA.

Keywords: Carcinogenesis; Chemotherapy; Lynch syndrome; Prognostic factor; Rare tumor; Small intestine adenocarcinoma.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / genetics*
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / therapy
  • Adenomatous Polyposis Coli Protein / genetics
  • Capsule Endoscopy
  • Chemotherapy, Adjuvant
  • Digestive System Surgical Procedures
  • Double-Balloon Enteroscopy
  • Duodenal Neoplasms / diagnosis
  • Duodenal Neoplasms / genetics*
  • Duodenal Neoplasms / metabolism
  • Duodenal Neoplasms / therapy
  • Humans
  • Intestinal Neoplasms / diagnosis
  • Intestinal Neoplasms / genetics
  • Intestinal Neoplasms / metabolism
  • Intestinal Neoplasms / therapy
  • Intestine, Small*
  • Mutation
  • Phenotype
  • Prognosis
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism
  • Risk Factors
  • Tomography, X-Ray Computed
  • Tumor Suppressor Protein p53 / metabolism
  • beta Catenin / metabolism


  • APC protein, human
  • Adenomatous Polyposis Coli Protein
  • KRAS protein, human
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • beta Catenin
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Proto-Oncogene Proteins p21(ras)