Background: Primary duodenal adenocarcinomas (PDAC) are uncommon tumors characterized by non-specific symptoms and late diagnosis, and treatments of PDAC have some controversies.
Method: To investigate the early diagnosis and outcomes of surgical treatment of PDAC, 32 patients who were treated surgically between February 1990 and September 2006 were analyzed retrospectively.
Results: All 32 patients underwent laparotomy, including 18 patients (56.3%) with pancreaticoduodenectomy (PD), six patients (18.7%) with segmental resection (SR), and eight patients with bypass procedures. And, R0 resections were obtained in 22 patients; the other ten procedures were palliative. The total 1-, 3-, and 5-year survival rates in this study were 86.2% (25 of 29), 48.3% (14 of 29), and 20.7% (six of 29), respectively. Moreover, the 1-, 3-, and 5-year survival rates in patients with R0 resection were 100.0% (19 of 19), 73.7% (14 of 19), and 31.6% (six of 19), which were significantly higher than those (50.0% = 5/10, 0% and 0%) in patients with palliative operation (P < 0.05), respectively. Furthermore, the 5-year survival rate was 27.8% (five of 18) in pancreaticoduodenectomy patients and 16.7% (one of six) in segmental resection patients, and there was no significant difference between the above two procedures (P > 0.05).
Conclusion: PD is suggested for the tumor located at the first and second portion of the duodenum, and SR may be appropriate for the selected patients, especially for tumors of the distal duodenum.
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