Carcinoma of the duodenum: management and survival in 14 cases.
OBJECTIVE
The aim of this study is to evaluate the role of surgery in the treatment of adenocarcinoma of the duodenum.


METHODS
From 1955 to 1994, 14 patients with primary adenocarcinoma of the duodenum underwent surgical treatment in our department. Presenting signs and symptoms were mainly related to obstruction and bleeding. Upper gastrointestinal contrast study, Computed Tomography (CT) and duodenoscopy were the primary diagnostic procedure modalities. All diagnoses were confirmed histologically. The tumors were staged pathologically according to the new TNM classification (UICC, 1992). Eight patients received palliative treatment or exploratory laparotomy. The remaining 6 patients were resectable for cure.


RESULTS
Operative mortality was 35.7%. The 5-year survival rate for patients who underwent curative resection was 33.3%. None of the patients who underwent palliative procedures or exploratory laparotomy survived for more than 11 months.


CONCLUSIONS
In the management of resectable adenocarcinomas of the duodenum surgical radicality including lymphadenectomy should be pursued. Unresectable adenocarcinomas treated with palliative procedure had a very poor prognosis.
Cangemi
V
V
1st Department of Surgery, University of Rome La Sapienza, Italy.
Volpino
P
P
Gentili
S
S
Giuliani
A
A
Di Martino
M
M
Cangemi
R
R
Clementi
M
M
Piat
G P
GP
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004379:Duodenal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate