Surgical treatment of non-ampullary duodenal cancer: good long term survival after radical tumour resection including lymphadenectomy.
OBJECTIVE
The aim of this study is to evaluate the role of surgery in the treatment of duodenal cancer.


METHODS
From October 1987 to January 1999, 7 patients (3 female/4 male) with primary non-ampullary duodenal adenocarcinoma underwent surgical treatment in our department. Presenting signs and symptoms were abdominal pain, weight loss, anaemia and obstruction. Upper gastrointestinal contrast study, computed tomography (CT) and duodenoscopy were the primary diagnostic procedure modalities. All diagnoses were confirmed histologically. Five of 7 patients were resectable for cure at the time of their first surgical intervention.


RESULTS
In 5 patients, the tumour could be removed with tumour-free margins. One patient, where the histopathological workup revealed tumour cells in the resection margins, died 29 months after the surgical intervention. In another patient, complete tumour resection could not be achieved. Subsequently, postoperative survival was only 2 months. Operative mortality was 0%. Patients with R0-status showed a postoperative survival of at least 24 months.


CONCLUSIONS
In the management of resectable non-ampullary malignancies of the duodenum, surgical radicality including lymphadenectomy should be pursued. The radical operative treatment with lymphadenectomy offers a reasonable chance for cure in some patients.
Schütz
G
G
Chirurgische Klinik, Kliniken der Landeshaupstadt Düsseldorf, Krankenhaus Gerresheim, Germany.
Aleksic
M
M
Ulrich
B
B
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004379:Duodenal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011379:Prognosis