Cangemi V, Volpino P, Gentili S, Giuliani A, Di Martino M, Cangemi R, Clementi M, Piat G P
1st Department of Surgery, University of Rome La Sapienza, Italy.
Panminerva Med. 1997 Mar;39(1):24-9.
The aim of this study is to evaluate the role of surgery in the treatment of adenocarcinoma of the duodenum.
From 1955 to 1994, 14 patients with primary adenocarcinoma of the duodenum underwent surgical treatment in our department. Presenting signs and symptoms were mainly related to obstruction and bleeding. Upper gastrointestinal contrast study, Computed Tomography (CT) and duodenoscopy were the primary diagnostic procedure modalities. All diagnoses were confirmed histologically. The tumors were staged pathologically according to the new TNM classification (UICC, 1992). Eight patients received palliative treatment or exploratory laparotomy. The remaining 6 patients were resectable for cure.
Operative mortality was 35.7%. The 5-year survival rate for patients who underwent curative resection was 33.3%. None of the patients who underwent palliative procedures or exploratory laparotomy survived for more than 11 months.
In the management of resectable adenocarcinomas of the duodenum surgical radicality including lymphadenectomy should be pursued. Unresectable adenocarcinomas treated with palliative procedure had a very poor prognosis.
本研究旨在评估手术在十二指肠腺癌治疗中的作用。
1955年至1994年，我科对14例原发性十二指肠腺癌患者进行了手术治疗。主要的症状和体征与梗阻和出血有关。上消化道造影、计算机断层扫描（CT）和十二指肠镜检查是主要的诊断方法。所有诊断均经组织学证实。根据新的TNM分类（国际抗癌联盟，1992年）对肿瘤进行病理分期。8例患者接受了姑息治疗或剖腹探查术。其余6例患者可进行根治性切除。
手术死亡率为35.7%。接受根治性切除的患者5年生存率为33.3%。接受姑息性手术或剖腹探查术的患者无一存活超过11个月。
在可切除的十二指肠腺癌治疗中，应追求包括淋巴结清扫在内的手术根治性。接受姑息性手术治疗的不可切除腺癌预后很差。
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