Clinicopathological analysis and survival outcome of duodenal adenocarcinoma
Duodenal adenocarcinoma is a rare cancer, contributing <10 % of periampullary carcinoma. This study reviews the single center experience of duodenal adenocarcinoma and analyzes the clinical and pathological factors to predict survival and recurrence. The records of 50 patients with duodenal adeno...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2014-05-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X13003069 |
| _version_ | 1819229529416138752 |
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| author | Myung Jin Kim Sae Byeol Choi Hyung Joon Han Pyoung Jae Park Wan Bae Kim Tae Jin Song Sung Ock Suh Sang Yong Choi |
| author_facet | Myung Jin Kim Sae Byeol Choi Hyung Joon Han Pyoung Jae Park Wan Bae Kim Tae Jin Song Sung Ock Suh Sang Yong Choi |
| author_sort | Myung Jin Kim |
| collection | DOAJ |
| description | Duodenal adenocarcinoma is a rare cancer, contributing <10 % of periampullary carcinoma. This study reviews the single center experience of duodenal adenocarcinoma and analyzes the clinical and pathological factors to predict survival and recurrence. The records of 50 patients with duodenal adenocarcinoma who underwent surgical exploration or resection from 1995 to 2010 were reviewed retrospectively. Univariate and multivariate analyses were performed to identify the clinicopathological factors associated with survival and recurrence. There were 35 men and 15 women, with a mean age of 61 years. In multivariate analysis of 50 patients, R0 resection [p = 0.041, hazard ratio (HR) = 3.569, 95% confidence interval (CI) = 1.057–12.054] and symptom at initial admission (p = 0.025, HR = 11.210, 95% CI = 1.354–92.812) were independent prognostic factors for overall survival. Thirty-six patients underwent curative resection (resectability 72%). The 5-year survival rates for curative and noncurative resections were 46.4% and 0%, respectively. Univariate analysis of 36 patients who underwent R0 resection revealed that symptoms at initial admission (p = 0.023), presence of lymph node metastasis (p = 0.034), and perineural invasion (p = 0.025) were significant prognostic factors after curative resection. There was no significant factor for overall survival in the multivariate analysis. There was recurrence in 15 patients, mainly as liver metastasis. Multivariate analysis revealed that presence of symptom (p = 0.047, HR = 5.362, 95% CI = 1.021–28.149) and ulcerative tumor (p = 0.036, HR = 5.668, 95% CI = 1.123–28.619) were independent factors for disease free survival. An aggressive surgical approach to achieve R0 resection was important to enhance survival. Most of the recurrence occurred within 1 year after surgery. Close follow-up is necessary after surgical resection. |
| first_indexed | 2024-12-23T11:14:37Z |
| format | Article |
| id | doaj.art-c149ce31a88d403895d3e717cf7aa313 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-23T11:14:37Z |
| publishDate | 2014-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-c149ce31a88d403895d3e717cf7aa3132022-12-21T17:49:15ZengWileyKaohsiung Journal of Medical Sciences1607-551X2014-05-0130525425910.1016/j.kjms.2013.12.006Clinicopathological analysis and survival outcome of duodenal adenocarcinomaMyung Jin KimSae Byeol ChoiHyung Joon HanPyoung Jae ParkWan Bae KimTae Jin SongSung Ock SuhSang Yong ChoiDuodenal adenocarcinoma is a rare cancer, contributing <10 % of periampullary carcinoma. This study reviews the single center experience of duodenal adenocarcinoma and analyzes the clinical and pathological factors to predict survival and recurrence. The records of 50 patients with duodenal adenocarcinoma who underwent surgical exploration or resection from 1995 to 2010 were reviewed retrospectively. Univariate and multivariate analyses were performed to identify the clinicopathological factors associated with survival and recurrence. There were 35 men and 15 women, with a mean age of 61 years. In multivariate analysis of 50 patients, R0 resection [p = 0.041, hazard ratio (HR) = 3.569, 95% confidence interval (CI) = 1.057–12.054] and symptom at initial admission (p = 0.025, HR = 11.210, 95% CI = 1.354–92.812) were independent prognostic factors for overall survival. Thirty-six patients underwent curative resection (resectability 72%). The 5-year survival rates for curative and noncurative resections were 46.4% and 0%, respectively. Univariate analysis of 36 patients who underwent R0 resection revealed that symptoms at initial admission (p = 0.023), presence of lymph node metastasis (p = 0.034), and perineural invasion (p = 0.025) were significant prognostic factors after curative resection. There was no significant factor for overall survival in the multivariate analysis. There was recurrence in 15 patients, mainly as liver metastasis. Multivariate analysis revealed that presence of symptom (p = 0.047, HR = 5.362, 95% CI = 1.021–28.149) and ulcerative tumor (p = 0.036, HR = 5.668, 95% CI = 1.123–28.619) were independent factors for disease free survival. An aggressive surgical approach to achieve R0 resection was important to enhance survival. Most of the recurrence occurred within 1 year after surgery. Close follow-up is necessary after surgical resection.http://www.sciencedirect.com/science/article/pii/S1607551X13003069Duodenal cancerLymph node metastasisPancreaticoduodenectomyR0 resection |
| spellingShingle | Myung Jin Kim Sae Byeol Choi Hyung Joon Han Pyoung Jae Park Wan Bae Kim Tae Jin Song Sung Ock Suh Sang Yong Choi Clinicopathological analysis and survival outcome of duodenal adenocarcinoma Kaohsiung Journal of Medical Sciences Duodenal cancer Lymph node metastasis Pancreaticoduodenectomy R0 resection |
| title | Clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| title_full | Clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| title_fullStr | Clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| title_full_unstemmed | Clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| title_short | Clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| title_sort | clinicopathological analysis and survival outcome of duodenal adenocarcinoma |
| topic | Duodenal cancer Lymph node metastasis Pancreaticoduodenectomy R0 resection |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X13003069 |
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