Survival outcomes in small intestine tumors: The role of duodenum, jejunum, and ileum

Small intestine tumors are rare, with variable prognostic factors. The impact of tumor location on survival outcomes remains controversial. This study explores the influence of tumor location (duodenum, jejunum, ileum) on survival. We analyzed data from the SEER database for small intestine cancer patients diagnosed between 2010 and 2017. Survival outcomes by tumor location were assessed using the Kaplan-Meier method and competing risk models, stratified by adenocarcinoma (ADC), neuroendocrine tumor (NET), and gastrointestinal stromal tumor (GIST). Propensity score matching (PSM) was employed to adjust for confounders. The cohort included 6047 patients: 2611 with duodenum, 2584 with ileum, and 852 with jejunum tumors. ADC was predominant in the duodenum (51.4%), while NET was most common in the ileum (84.21%). Overall, the ileum tumors had the best prognosis, and duodenum tumors had the worst (p < .001). In ADC, duodenum tumors had the poorest overall (OS) and disease-specific survival (DSS) (p < .001) with no significant impact of location in GIST (p > .05). The competing risk model indicated better prognosis for jejunum versus duodenum in ADC (HR = 0.80, p = .048) and similar risks between ileum and duodenum tumors (HR = 0.99, p = .94), while location did not affect prognosis in GIST and NET (p > .05). Post-PSM, survival curves reconfirmed no significant difference between duodenum and ileum ADC (p > .05). Tumor location significantly influences prognosis in small intestine ADC, with duodenum tumors showing the worst outcomes. Location was not a significant prognostic factor in GIST and NET.