Gastrointestinal tumors of the small bowel: prognostic roles of tumor stage and inflammatory markers

Abstract

Aims: Small bowel tumors are a heterogeneous group of malignancies, including gastrointestinal stromal tumors (GISTs), adenocarcinomas, neuroendocrine tumors (NETs), and myofibroblastic tumors, each with distinct prognostic implications. While tumor stage is a well-established prognostic factor, patient survival outcomes and systemic inflammatory markers also play a crucial role in disease progression. This study evaluates these factors comprehensively to enhance prognostic assessment in small bowel malignancies. Methods: This retrospective study analyzed 25 patients diagnosed with small bowel tumors, including various histological subtypes. The prognostic significance of tumor stage (T and N classification), systemic inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], albumin, and C-reactive protein [CRP]), and overall survival was assessed. Kaplan-Meier survival analysis was conducted to evaluate the association between tumor stage, inflammatory markers, and patient outcomes. Statistical analyses included independent sample t-tests, Mann-Whitney U tests, and Chi-square tests. Results: The median age of the cohort was 63 years (range: 47–81). The most common histological subtype was GIST (52%), followed by adenocarcinoma (24%), NET (20%), and myofibroblastic tumors (4%). Kaplan-Meier survival analysis revealed a significant association between tumor stage and patient survival (p=0.036), with advanced-stage tumors (T3–T4) demonstrating significantly lower survival rates compared to early-stage tumors (T2). Lymph node involvement (N stage) was also a significant predictor of reduced survival (p=0.013). Although inflammatory markers such as NLR, PLR, albumin, and CRP were assessed, they did not show statistically significant associations with survival outcomes (p>0.05). Conclusion: This study highlights the importance of evaluating both tumor stage and patient survival when determining prognosis in small bowel tumors. The Kaplan-Meier analysis underscores the strong prognostic impact of tumor staging and lymph node involvement on survival outcomes. Although systemic inflammatory markers did not show significant prognostic value in this cohort, their role in risk stratification warrants further investigation in larger studies. These findings contribute to a broader understanding of small bowel tumor prognosis beyond staging alone, supporting the need for a multidimensional approach in clinical assessment and treatment planning.

Keywords

• Gastrointestinal stromal tumors (GISTs)
• inflammatory markers
• tumor stage
• neutrophil-to-lymphocyte ratio (NLR)
• platelet-to-lymphocyte ratio (PLR)
• survival analysis
• gastrointestinal tumors
• prognostic factors

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