Department of Surgery, Rigshospitalet, Copenhagen, Denmark.
Department of Surgery, Rigshospitalet, Copenhagen, Denmark.
Int J Surg. 2022 Apr;100:106599. doi: 10.1016/j.ijsu.2022.106599. Epub 2022 Mar 11.
Radical resection of duodenal adenocarcinoma (DA) offers the possibility of cure. The outcome after operation and adjuvant therapy is mainly based on small numbers due to the low incidence of the disease. We examined the long-term outcome after surgical treatment of DA.
This was a retrospective cohort study including all patients undergoing curatively intended resection for histologically confirmed DA at a single University hospital. Long-term survival was examined by the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox proportional hazards regression analysis was applied to adjust for confounding.
A total of 96 patients were included. The median follow-up was 3.7 years (IQR 2.9-4.3), during which 18 patients (18.5%) had recurrence and 35 (36.5%) patients had died. The 3- and 5-year overall survival was 66.3% (55.6-76.9%) and 58.2% (46.2-70.2%), respectively. In the multivariable analysis, adjuvant therapy was associated with decreased mortality (HR 0.29, CI 0.11-0.76, P = 0.011) whereas positive lymph node ratio >0.20 was associated with increased mortality.
Radical operation for DA has a median overall 5-year-survival of more than 50%. The indication for adjuvant chemotherapy remains to be addressed.
十二指肠腺癌（DA）的根治性切除术有治愈的可能。由于该病发病率低，手术后和辅助治疗的结果主要基于少数病例。我们研究了手术治疗 DA 的长期结果。
这是一项回顾性队列研究，包括在一家大学医院接受根治性切除术治疗组织学证实的 DA 的所有患者。通过 Kaplan-Meier 方法检查长期生存情况，并与对数秩检验进行比较。应用多变量 Cox 比例风险回归分析来调整混杂因素。
共纳入 96 例患者。中位随访时间为 3.7 年（IQR 2.9-4.3），18 例（18.5%）患者复发，35 例（36.5%）患者死亡。3 年和 5 年总生存率分别为 66.3%（55.6-76.9%）和 58.2%（46.2-70.2%）。多变量分析显示，辅助治疗与死亡率降低相关（HR 0.29，CI 0.11-0.76，P=0.011），而阳性淋巴结比率>0.20 与死亡率增加相关。
DA 的根治性手术有超过 5 年的中位总生存率。辅助化疗的适应证仍有待确定。
