BACKGROUND: Duodenal adenocarcinoma (DA) is rare, but potentially curable. Prospective data on treatment outcomes is scarce and large retrospective studies show conflicting results on the impact of radical resection, node-status, and adjuvant therapy. METHODS: In the past 17 years, 30 patients presented with resectable DA. Data on the aforementioned variables were acquired then analyzed for impact on recurrence and survival. RESULTS: Overall-survival rates at 1, 2, and 3 years were 70.0%, 53.3%, and 33.3% respectively. Recurrence-free survival rates at 1, 2, and 3 years were 53.3%, 30.0%, and 26.7%. Overall-survival rates for patients with node-positive disease at 1, 2, and 3 years were 68.8%, 43.8%, 12.5%, and for node-negative 70%, 60%, 60%. Recurrence-free survival in node-positive disease at 1, 2, 3 years was 50%, 12.5%, 12.5%, and for node negative 50%, 50%, and 40%. Median survival from diagnosis was 27.5 months (0.5-226.7 months). Significant predictors of recurrence and survival were nodal-status and AJCC stage (P < 0.001). Adjuvant therapy, surgical-type, pathological tumor-stage, and surgical margins were not significant. CONCLUSION: Nodal-status and overall pathological-stage significantly affect the prognosis for patients with DA, while resection-status and adjuvant therapy may not. The role of adjuvant therapy requires prospective trials for elucidation.
BACKGROUND:Duodenal adenocarcinoma (DA) is rare, but potentially curable. Prospective data on treatment outcomes is scarce and large retrospective studies show conflicting results on the impact of radical resection, node-status, and adjuvant therapy. METHODS: In the past 17 years, 30 patients presented with resectable DA. Data on the aforementioned variables were acquired then analyzed for impact on recurrence and survival. RESULTS: Overall-survival rates at 1, 2, and 3 years were 70.0%, 53.3%, and 33.3% respectively. Recurrence-free survival rates at 1, 2, and 3 years were 53.3%, 30.0%, and 26.7%. Overall-survival rates for patients with node-positive disease at 1, 2, and 3 years were 68.8%, 43.8%, 12.5%, and for node-negative 70%, 60%, 60%. Recurrence-free survival in node-positive disease at 1, 2, 3 years was 50%, 12.5%, 12.5%, and for node negative 50%, 50%, and 40%. Median survival from diagnosis was 27.5 months (0.5-226.7 months). Significant predictors of recurrence and survival were nodal-status and AJCC stage (P < 0.001). Adjuvant therapy, surgical-type, pathological tumor-stage, and surgical margins were not significant. CONCLUSION: Nodal-status and overall pathological-stage significantly affect the prognosis for patients with DA, while resection-status and adjuvant therapy may not. The role of adjuvant therapy requires prospective trials for elucidation.
Authors: George A Poultsides; Lyen C Huang; John L Cameron; Richard Tuli; Leslie Lan; Ralph H Hruban; Timothy M Pawlik; Joseph M Herman; Barish H Edil; Nita Ahuja; Michael A Choti; Christopher L Wolfgang; Richard D Schulick Journal: Ann Surg Oncol Date: 2011-12-14 Impact factor: 5.344
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Authors: Sally Tamraz; Ali Shamseddine; Manish Shah; Mohamed El-Oubeidi; Ghazi Zaatari; Fady Geara; Maeve A Lowery; Eileen M O'Reilly; Aghiad Al-Kutoubi; Walid Faraj; David P Kelsen; Ghassan K Abou-Alfa Journal: Gastrointest Cancer Res Date: 2012-05
Authors: Edwin O Onkendi; Sarah Y Boostrom; Michael G Sarr; Michael B Farnell; David M Nagorney; John H Donohue; Michael L Kendrick; Kaye M Reid-Lombardo; William S Harmsen; Florencia G Que Journal: J Gastrointest Surg Date: 2012-02-17 Impact factor: 3.452
Authors: Maryam Zenali; Michael J Overman; Asif Rashid; Russell B Broaddus; Hua Wang; Matthew H Katz; Jason B Fleming; James L Abbruzzese; Huamin Wang Journal: Hum Pathol Date: 2013-10-15 Impact factor: 3.466