Retrospective analysis of prognostic factors in patients with duodenal adenocarcinoma

被引:2
作者
Teoule, P. [1 ]
Distler, M. [2 ]
Niedergethmann, M. [3 ]
Gaiser, T. [4 ]
Rueckert, F. [1 ]
Gruetzmann, R. [2 ]
Wilhelm, T. J. [1 ]
机构
[1] Heidelberg Univ, Univ Med Ctr Mannheim, Med Fac Mannheim, Dept Surg, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany
[2] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Gen Thorac & Vasc Surg, Dresden, Germany
[3] Alfried Krupp Hosp, Dept Surg, Essen, Germany
[4] Heidelberg Univ, Med Fac Mannheim, Univ Med Ctr Mannheim, Inst Pathol, Mannheim, Germany
来源
EUROPEAN SURGERY-ACTA CHIRURGICA AUSTRIACA | 2016年 / 48卷 / 04期
关键词
Duodenal carcinoma; Curative resection; Prognostic factors; INTERNATIONAL STUDY-GROUP; PANCREATIC SURGERY ISGPS; POSTPANCREATECTOMY HEMORRHAGE; SURVIVAL; DEFINITION; RESECTION; PANCREATICODUODENECTOMY; AMPULLARY; CANCER; CHEMORADIATION;
D O I
10.1007/s10353-015-0374-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Sporadic duodenal cancer is a rare cancer entity. Therefore, the prognostic significance of clinicopathologic features is unknown. This study aimed to identify prognostic factors and compare survival with other tumour entities of the same anatomical region. Methods We retrospectively studied medical records of 22 patients with duodenal adenocarcinoma (DAC), who underwent resection in two German centres for pancreatic surgery (1994-2012). Mean time of follow-up was 51.3 months. Predictive factors were evaluated by log rank analysis. Results Whipple surgery was performed in seven cases (31.8 %), pylorus preserving pancreaticoduodenectomy in 14 cases (63.6 %) and partial duodenectomy in one case (4.5 %). R0-resection was achieved in 86.4 %. In all, 50% of our patients had nodal positive disease. Overall morbidity was 59.1 % and perioperative mortality was 9.1 %. Survival after resection was 63.6 % and 59.0 % (3- and 5-years). There was no significant survival difference between patients with DAC and ampullary cancer, but survival was longer compared with patients with pancreatic cancer. Conclusions Mortality seems to be high after resection of DAC. However, radical surgery should be performed due to the high number of patients with nodal positive disease. No definite prognostic factors were identified. The prognosis after resection of duodenal cancer can be compared with patients with ampullary cancer.
引用
收藏
页码:228 / 234
页数:7
相关论文
共 31 条
[1]  
ALLEMA JH, 1995, CANCER, V75, P2069, DOI 10.1002/1097-0142(19950415)75:8<2069::AID-CNCR2820750807>3.0.CO
[2]  
2-7
[3]   Postoperative pancreatic fistula: An international study group (ISGPF) definition [J].
Bassi, C ;
Dervenis, C ;
Butturini, G ;
Fingerhut, A ;
Yeo, C ;
Izbicki, J ;
Neoptolemos, J ;
Sarr, M ;
Traverso, W ;
Buchler, M .
SURGERY, 2005, 138 (01) :8-13
[4]   Superior Prognostic Importance of Perineural Invasion vs. Lymph Node Involvement After Curative Resection of Duodenal Adenocarcinoma [J].
Cecchini, Stefano ;
Correa-Gallego, Camilo ;
Desphande, Vikram ;
Ligorio, Matteo ;
Dursun, Abdulmetin ;
Wargo, Jennifer ;
Fernandez-del Castillo, Carlos ;
Warshaw, Andrew Louis ;
Ferrone, Cristina Rosa .
JOURNAL OF GASTROINTESTINAL SURGERY, 2012, 16 (01) :113-120
[5]   Adenocarcinoma of the small bowel: Presentation, prognostic factors, and outcome of 217 patients [J].
Dabaja, BS ;
Suki, D ;
Pro, B ;
Bonnen, M ;
Ajani, J .
CANCER, 2004, 101 (03) :518-526
[6]   Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma [J].
Distler, Marius ;
Rueckert, Felix ;
Hunger, Maximilian ;
Kersting, Stephan ;
Pilarsky, Christian ;
Saeger, Hans-Detlev ;
Gruetzmann, Robert .
BMC SURGERY, 2013, 13
[7]   Evaluation of the International Study Group of Pancreatic Surgery definition of post-pancreatectomy hemorrhage in a high-volume center [J].
Gruetzmann, Robert ;
Rueckert, Felix ;
Hippe-Davies, Nele ;
Distler, Marius ;
Saeger, Hans-Detlev .
SURGERY, 2012, 151 (04) :612-620
[8]   The surgical treatment and outcome for primary duodenal adenocarcinoma [J].
Han S.-L. ;
Cheng J. ;
Zhou H.-Z. ;
Zeng Q.-Q. ;
Lan S.-H. .
Journal of Gastrointestinal Cancer, 2010, 41 (4) :243-247
[9]   Should all patients with duodenal adenocarcinoma be considered for aggressive surgical resection? [J].
Hurtuk, M. G. ;
Devata, S. ;
Brown, K. M. ;
Oshima, K. ;
Aranha, G. V. ;
Pickleman, J. ;
Shoup, M. .
AMERICAN JOURNAL OF SURGERY, 2007, 193 (03) :319-324
[10]   Defining the Role of Adjuvant Therapy: Ampullary and Duodenal Adenocarcinoma [J].
Jabbour, Selma K. ;
Mulvihill, David .
SEMINARS IN RADIATION ONCOLOGY, 2014, 24 (02) :85-93