The surgical treatment and outcome for primary duodenal adenocarcinoma.

BACKGROUND

To investigate the early diagnosis and outcomes of surgical treatment of primary duodenal adenocarcinoma (PDAC) for curative purpose.

METHOD

Thirty-two PDAC patients treated surgically between February 1990 and September 2006 were analyzed retrospectively.

RESULTS

All 32 patients underwent laparotomy including 18 (56.3%) pancreaticoduodenectomy (PD), six (18.7%) segmental resection (SR), and eight bypass procedures. And R0 resections were obtained in 22 patients; the other ten procedures were palliative. The total 1-, 3-, and 5-year survival rates in this study were 78.1% (25/32), 43.8% (14/32), and 18.8% (6/32), respectively; moreover, the 1-, 3-, and 5-year survival rates in patients with R0 resection were 100.0% (20/20), 70.0% (14/20), and 30.0% (6/20), which were significantly higher than those (41.7% =  /12, 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).

CONCLUSION

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.