Improving survival in adenocarcinoma of the duodenum.

The records of 104 patients with primary adenocarcinoma of the duodenum were reviewed. All patients were followed up to the date of this report, 91 for at least 5 years. Melena was an ominous preoperative finding. Survival was directly related to nodal status, the grade of the lesion, and the ability of the surgeon to minimize or eliminate operative mortality. Fifty percent of the lesions were resectable for cure, and the 5 year survival rate for patients with resectable lesions was 46 percent. All eight patients treated with segmental resections for lesions in the third and fourth portions of the duodenum survived at least 5 years. These data are a great improvement over those in previous reports and suggest that this disease may be much more treatable than previously believed.