Different survival outcomes of small bowel adenocarcinomas and T-cell lymphomas associated to celiac disease.

in The American journal of gastroenterology by Giovanni Santacroce, Alessandro Vanoli, Nicola Aronico, Paola Ilaria Bianchi, Marco Vincenzo Lenti, Carolina Ciacci, Fabiana Zingone, Umberto Volta, Antonio Calabrò, Luca Elli, Rachele Ciccocioppo, Gino Roberto Corazza, Marco Lucioni, Marco Paulli, Antonio Di Sabatino,

TLDR

  • The study found that CD-associated small bowel adenocarcinoma (SBA) had a significantly better survival rate than CD-associated T-cell lymphoma (TCL).

Abstract

Small bowel adenocarcinoma (SBA) and T-cell lymphoma (TCL) are rare but aggressive malignancies associated with celiac disease (CD). We retrospectively compared 43 CD-associated SBA and 43 CD-associated TCL across international referral centers. CD-associated SBA showed a significantly (p<0.01) better survival than CD-associated TCL. TCL more frequently presented with multifocal involvement and advanced stage, whereas SBA predominantly involved the jejunum. Refractoriness to a gluten-free diet was identified in 70% of TCL, but only in one SBA. Our findings demonstrated a worse prognosis of CD-associated TCL in comparison to CD-associated SBA.

Overview

  • The study retrospectively compared 43 cases of small bowel adenocarcinoma (SBA) and 43 cases of T-cell lymphoma (TCL) associated with celiac disease (CD) across international referral centers.
  • The study aimed to investigate the clinical and pathological characteristics of SBA and TCL in patients with CD, and to determine if there were any differences in survival rates between the two groups.
  • The primary objective of the study was to identify the key factors that contributed to the worse prognosis of TCL compared to SBA in patients with CD.

Comparative Analysis & Findings

  • The study found that CD-associated SBA had a significantly better survival rate than CD-associated TCL (p<0.01).
  • TCL was more likely to present with multifocal involvement and advanced stage, whereas SBA predominantly involved the jejunum.
  • There was a significant difference in the frequency of refractoriness to a gluten-free diet, with 70% of TCL patients experiencing refractoriness compared to only 2.3% of SBA patients.

Implications and Future Directions

  • The study's findings highlight the importance of early detection and treatment of SBA and TCL in patients with CD to improve survival rates.
  • Further research is needed to identify the molecular mechanisms underlying the worse prognosis of TCL compared to SBA in patients with CD.
  • The study's findings may also have implications for the development of novel therapies for the treatment of TCL in patients with CD.
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