Premium
Non‐ampullary duodenal adenocarcinoma: Factors important for relapse and survival
Author(s) -
Struck Aaron,
Howard Thomas,
Chiorean Elena G.,
Clarke Jeffrey M.,
Riffenburgh Robert,
Cardenes Higinia R.
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21319
Subject(s) - medicine , adjuvant therapy , stage (stratigraphy) , adenocarcinoma , pathological , surgery , survival rate , prospective cohort study , adjuvant , retrospective cohort study , gastroenterology , oncology , chemotherapy , cancer , paleontology , biology
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. J. Surg. Oncol. 2009;100:144–148. © 2009 Wiley‐Liss, Inc.