Bendixen Morten, Dahl Sune, Fristrup Claus, Mortensen Michael Bau
Kirurgisk Afdeling A, Odense Universitetshospital, 5000 Odense C, Denmark.
Ugeskr Laeger. 2010 May 3;172(18):1376-9.
Primary adenocarcinoma of the duodenum is a rare disease in this part of the world, and data on survival following curative and palliative treatment are scarce.
All patients treated for duodenal cancer (DC) at the Department of Surgery, Odense University Hospital, between January 1995 and February 2006 were retrospectively evaluated. Tumours arising from the pancreatic head, the papilla of Vater, distal bile duct or tumour infiltration from surrounding organs (apart from the duodenum) were excluded.
Eleven (31%) of the 35 included patients (17 women and 18 men, median age 62 years, range 45-88 years) received a curative resection (R0 resection), while 24 patients had surgical or endoscopic palliation. Survival following R0 resection was significantly higher than survival in the palliative group (p = 0.0002). The median survival was 45 months (confidence interval (CI) 6- ) in the R0 group versus 5.3 months (CI 2-11) in the palliative group.
In a consecutive, but retrospective DC population, we found that only one third of the patients were candidates for a curative resection, and despite microscopical, radical surgery only one third were alive after five years.
在世界的这个地区,十二指肠原发性腺癌是一种罕见疾病,关于根治性和姑息性治疗后的生存数据很少。
对1995年1月至2006年2月在欧登塞大学医院外科接受十二指肠癌(DC)治疗的所有患者进行回顾性评估。排除起源于胰头、Vater壶腹、远端胆管的肿瘤或来自周围器官(除十二指肠外)的肿瘤浸润。
35例纳入患者中(17例女性和18例男性,中位年龄62岁,范围45 - 88岁),11例(31%)接受了根治性切除(R0切除),而24例患者接受了手术或内镜姑息治疗。R0切除后的生存率显著高于姑息治疗组(p = 0.0002)。R0组的中位生存期为45个月(置信区间(CI)6 - ),而姑息治疗组为5.3个月(CI 2 - 11)。
在一个连续但为回顾性的DC患者群体中,我们发现只有三分之一的患者适合进行根治性切除,并且尽管进行了显微镜下的根治性手术,五年后仍只有三分之一的患者存活。