Adenocarcinoma of the Duodenum

Factors Influencing Long-Term Survival

Taylor A. Sohn, Keith D. Lillemoe, John L. Cameron, Henry A. Pitt, Howard S. Kaufman, Ralph H. Hruban, Charles J. Yeo

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

This single-institution retrospective analysis reviews the management and outcome of patients with surgically treated adenocarcinoma of the duodenum. Between February 1984 and August 1996, fifty-five patients with adenocarcinoma of the duodenum underwent surgery at The Johns Hopkins Hospital. Univariate analysis was performed to identify possible prognostic indicators. Curative resection was performed in 48 patients (87%): 35 of these patients (73%) underwent a pancreaticoduodenectomy (PD), whereas 27% (n = 13) underwent a pancreas-sparing duodenectomy (PSD). Patients undergoing PD were comparable to those undergoing PSD with respect to demographic factors, presenting symptoms, and tumor pathology. The remaining 13% of patients (n = 7) were deemed unresectable at the time of surgery and underwent biopsy and/or palliative bypass. PD was associated with an increase in postoperative complications when compared to PSD (57% vs. 30%), but this difference was not statistically significant. One perioperative death occurred following PD (mortality 2.9%). The overall 5-year survival rate for the 48 patients undergoing potentially curative resection was 53%. Negative resection margins (P <0.001), PD (P <0.005), and tumors in the first and second portions of the duodenum (P <0.05) were favorable predictors of long-term survival by univariate analysis. Nodal status, tumor diameter, degree of differentiation, and the use of adjuvant chemoradiation therapy did not influence survival. These data support an aggressive role for resection in patients with adenocarcinoma of the duodenum.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume2
Issue number1
StatePublished - Jan 1998
Externally publishedYes

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Duodenum
Adenocarcinoma
Pancreaticoduodenectomy
Survival
Pancreas
Neoplasms
Survival Analysis
Survival Rate
Demography
Pathology
Biopsy
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Sohn, T. A., Lillemoe, K. D., Cameron, J. L., Pitt, H. A., Kaufman, H. S., Hruban, R. H., & Yeo, C. J. (1998). Adenocarcinoma of the Duodenum: Factors Influencing Long-Term Survival. Journal of Gastrointestinal Surgery, 2(1), 79-87.

Adenocarcinoma of the Duodenum : Factors Influencing Long-Term Survival. / Sohn, Taylor A.; Lillemoe, Keith D.; Cameron, John L.; Pitt, Henry A.; Kaufman, Howard S.; Hruban, Ralph H.; Yeo, Charles J.

In: Journal of Gastrointestinal Surgery, Vol. 2, No. 1, 01.1998, p. 79-87.

Research output: Contribution to journalArticle

Sohn, TA, Lillemoe, KD, Cameron, JL, Pitt, HA, Kaufman, HS, Hruban, RH & Yeo, CJ 1998, 'Adenocarcinoma of the Duodenum: Factors Influencing Long-Term Survival', Journal of Gastrointestinal Surgery, vol. 2, no. 1, pp. 79-87.
Sohn TA, Lillemoe KD, Cameron JL, Pitt HA, Kaufman HS, Hruban RH et al. Adenocarcinoma of the Duodenum: Factors Influencing Long-Term Survival. Journal of Gastrointestinal Surgery. 1998 Jan;2(1):79-87.
Sohn, Taylor A. ; Lillemoe, Keith D. ; Cameron, John L. ; Pitt, Henry A. ; Kaufman, Howard S. ; Hruban, Ralph H. ; Yeo, Charles J. / Adenocarcinoma of the Duodenum : Factors Influencing Long-Term Survival. In: Journal of Gastrointestinal Surgery. 1998 ; Vol. 2, No. 1. pp. 79-87.
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