Research Report
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2014; 20(13): 3628-3634
Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3628
Tumors of the angle of Treitz: A single-center experience
Yi-Bin Xie, Hao Liu, Liang Cui, Gu-Sheng Xing, Lin Yang, Yue-Min Sun, Xiao-Feng Bai, Dong-Bing Zhao, Cheng-Feng Wang, Yan-Tao Tian
Yi-Bin Xie, Hao Liu, Liang Cui, Yue-Min Sun, Xiao-Feng Bai, Dong-Bing Zhao, Cheng-Feng Wang, Yan-Tao Tian, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Gu-Sheng Xing, Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Lin Yang, Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
Author contributions: Xie YB, Liu H, Cui L, Xing GS, Yang L, Sun YM, Bai XF, Zhao DB and Wang CF performed the research; Xie YB and Tian YT were involved in designing the study and editing the manuscript.
Supported by Beijing Municipal Science Technology Commission Fund No. Z131107002213164 and the Beijing Hope Run Special Fund LC2012A09
Correspondence to: Yan-Tao Tian, MD, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan Jia Yuan Nan Li, Beijing 100021, China. tyt67@163.com
Telephone: +86-10-87787120 Fax: +86-10-67730386
Received: January 2, 2014
Revised: February 10, 2014
Accepted: March 7, 2014
Published online: April 7, 2014
Abstract

AIM: To explore the feasibility and oncologic outcomes of segmental jejunal resection on the left side of the mesenteric vessels in patients with tumors of the angle of Treitz using data from a single center.

METHODS: Thirteen patients with tumors of the angle of Treitz who underwent surgery at our institution were prospectively followed. A segmental jejunal resection on the left side of the mesenteric vessels was performed in all patients. Formalin-fixed and paraffin-embedded tumor samples were examined. The primary end point of this analysis was disease-free survival.

RESULTS: In this study, there were 8 males and 5 females (mean age, 50.1 years; range, 36-74 years). The mean tumor size was 8.1 cm (range, 3.2-15 cm). Histologic examination showed 11 gastrointestinal stromal tumors (GISTs) and 2 adenocarcinomas. Five of the GIST patients presented with potential low risk, and 6 presented with intermediate and high risk, according to the National Institutes of Health criteria. One potentially high-risk patient showed tumor progression at 46 mo and died 52 mo after surgery. One patient with locally advanced adenocarcinoma received neoadjuvant chemotherapy and adjuvant radiotherapy, but the disease progressed, and the patient died 9 mo after surgery. One GIST patient without progression died 16 mo after surgery because of a postoperative intestinal obstruction. The median overall survival rate was 84.6 mo, and the median disease-free survival rate was 94.5 mo.

CONCLUSION: The overall survival of patients with tumors of the angle of Treitz was encouraging even when the tumor size was relatively large. A segmental resection on the left side of the mesenteric vessels is considered to be a reliable and curative option for tumors of the angle of Treitz.

Keywords: Gastrointestinal stromal tumor, Adenocarcinoma, Angle of Treitz, Surgical treatment, Prognosis

Core tip: This single-center study investigated a type of rare tumor originating from the angel of Treitz. The symptoms, diagnosis, surgical procedure, histology, and prognosis were evaluated. Although the tumors tended to be large, segmental jejunal resection on the left side of the mesenteric vessels was the treatment of choice.