title: Villous tumors of the duodenum: a retrospective study of 47 cases by the French Associations for Surgical Research.
abstract: BACKGROUND
  We evaluated villous tumors of the duodenum in regard to preoperative diagnosis of malignancy and the choice of treatment.
  
  
  METHODS
  From January 1974 to October 1992, forty-seven patients with a benign or malignant tumor arising from the duodenal mucosa were studied. Forty-two patients underwent a macroscopically complete resection of the tumor. Nineteen tumors were malignant.
  
  
  RESULTS
  Preoperative endoscopic biopsy results had a 52 percent sensitivity and 100 percent specificity for the diagnosis of malignancy. For the 42 patients who underwent complete resection, jaundice was predictive of malignancy (p < 0.01), whereas tumor size was not (p < 0.2). The five-year survival rate of this group was 69.5 percent (confidence interval: 50 to 84). The recurrence rate was higher (p < 0.01) and the survival rate shorter (p < 0.001) for patients who underwent ampullectomy (n = 8) compared with patients treated by limited resection (n = 20) or pancreatoduodenectomy (n = 14).
  
  
  CONCLUSIONS
  Preoperative diagnosis of malignancy is difficult for villous tumors of the duodenum. For tumors located near the papilla, it seems that pancreatoduodenectomy is the best treatment.
authors.affiliation: Department of Digestive Surgery, Hôtel-Dieu, Clermont-Ferrand, France.
authors.forename: D
authors.initials: D
authors.lastname: Pezet
authors.forename: N
authors.initials: N
authors.lastname: Rotman
authors.forename: K
authors.initials: K
authors.lastname: Slim
authors.forename: M J
authors.initials: MJ
authors.lastname: Boudet
authors.forename: J
authors.initials: J
authors.lastname: Chipponi
authors.forename: P L
authors.initials: PL
authors.lastname: Fagniez
mesh_terms: D000206:Actuarial Analysis; D018253:Adenoma, Villous / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000368:Aged; D001706:Biopsy; D016001:Confidence Intervals; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D004384:Duodenoscopy; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012955:Societies, Medical; D015996:Survival Rate; D014057:Tomography, X-Ray Computed