title: Surgical treatment of primary duodenal adenocarcinoma.
abstract: OBJECTIVE
  Our purpose was to review the outcome of the patients with primary duodenal adenocarcinoma and determine factors influencing survival.
  
  
  METHODS
  Over a 10-year period, 43 patients with this disease were identified. Data were analyzed to assess the outcomes of treatment and predictors of survival.
  
  
  RESULTS
  Patients had symptoms present for an average of 6 months. The most common symptom was obstructive jaundice, observed in 55.8% of the cases. Based on symptomology, primary duodenal adenocarcinoma may be classified into three categories: icteric, obstructive and illusive. The upper gastrointestinal contrast study and esophagogastroduodenoscopy were the most effective diagnostic tests, showing an accuracy of 79.5% and 86.8%, respectively. A curative resection was performed in 28 of the 43 patients (65.1%), a conventional pancreatoduodenectomy in 11, segmental duodenal resection in 16 and gastroduodenectomy in 1. The overall 5-year survival rate was 27%, which was 42 percent after curative resection.
  
  
  CONCLUSIONS
  The respectability of the primary lesion was associated with increased survival. An aggressive surgical approach should be pursued. Pancreaticoduodenectomy is usually required for tumors of the first and second portion of the duodenum. Segmental resection may be appropriate for selected patients, especially for cancers of the distal duodenum.
authors.affiliation: Department of General Surgery, the Second Affiliated Hospital, XiangYa Medical College Central South University, ChangSha, P.R. China. hujixiong@medmail.com.cn
authors.forename: Ji-Xiong
authors.initials: JX
authors.lastname: Hu
authors.forename: Xiong-Ying
authors.initials: XY
authors.lastname: Miao
authors.forename: De-Wu
authors.initials: DW
authors.lastname: Zhong
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Dai
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D004379:Duodenal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D016896:Treatment Outcome