The Surgical Treatment and Outcome for Primary Duodenal Adenocarcinoma

• DOI: 10.1007/s12029-009-9061-3
• Publication Date: 2009-04-27T10:26:34Z
• Authors: Shao-Liang Han; Jun Cheng; Hong-Zhong Zhou; Qi-Qiang Zeng; Sheng-Hong Lan
• Keywords: Adult; Male; Kaplan-Meier Estimate; Adenocarcinoma; Middle Aged; 3. Good health; Survival Rate; Treatment Outcome; Duodenal Neoplasms; Lymphatic Metastasis; Humans; Female; Tomography, X-Ray Computed; Digestive System Surgical Procedures; Aged; Neoplasm Staging; Retrospective Studies

The purpose of this study was to investigate the early diagnosis and outcomes of surgical treatment of primary duodenal adenocarcinoma (PDAC) for curative purpose.Thirty-two PDAC patients treated surgically between February 1990 and September 2006 were analyzed retrospectively.All 32 patients underwent laparotomy, including 18 patients (56.3%) pancreaticoduodenectomy (PD), six patients (18.7%) segmental resection (SR), and eight patients bypass procedures. R0 resections were obtained in 22 patients; the other 10 procedures were palliative. The total 1-, 3-, and 5-year survival rates in this study were 86.2% (25/29), 48.3% (14/29), and 20.7% (6/29), respectively, moreover, the 1-, 3-, and 5-year survival rates in patients with R0 resection were 100.0% (19/19), 73.7% (14/19), and 31.6%(6/19), which were significantly higher than those (50.0% = 5/10, 0%, and 0%) in patients with palliative operation (P > 0.05), respectively. Furthermore, the 5-year survival rate was 27.8% (5/18) in pancreaticoduodenectomy patients and 16.7% (1/6) in segmental resection patients, and there was no significant difference between the above two procedures (P > 0.05).PD is suggested for tumor located at the first and second portion of the duodenum, and SR may be appropriate for the selected patients, especially for tumors of the distal duodenum.