title: Non-ampullary duodenal adenocarcinoma: factors important for relapse and survival.
abstract: BACKGROUND
  Duodenal adenocarcinoma (DA) is rare, but potentially curable. Prospective data on treatment outcomes is scarce and large retrospective studies show conflicting results on the impact of radical resection, node-status, and adjuvant therapy.
  
  
  METHODS
  In the past 17 years, 30 patients presented with resectable DA. Data on the aforementioned variables were acquired then analyzed for impact on recurrence and survival.
  
  
  RESULTS
  Overall-survival rates at 1, 2, and 3 years were 70.0%, 53.3%, and 33.3% respectively. Recurrence-free survival rates at 1, 2, and 3 years were 53.3%, 30.0%, and 26.7%. Overall-survival rates for patients with node-positive disease at 1, 2, and 3 years were 68.8%, 43.8%, 12.5%, and for node-negative 70%, 60%, 60%. Recurrence-free survival in node-positive disease at 1, 2, 3 years was 50%, 12.5%, 12.5%, and for node negative 50%, 50%, and 40%. Median survival from diagnosis was 27.5 months (0.5-226.7 months). Significant predictors of recurrence and survival were nodal-status and AJCC stage (P < 0.001). Adjuvant therapy, surgical-type, pathological tumor-stage, and surgical margins were not significant.
  
  
  CONCLUSIONS
  Nodal-status and overall pathological-stage significantly affect the prognosis for patients with DA, while resection-status and adjuvant therapy may not. The role of adjuvant therapy requires prospective trials for elucidation.
authors: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Aaron
authors: A
authors: Struck
authors: Thomas
authors: T
authors: Howard
authors: Elena G
authors: EG
authors: Chiorean
authors: Jeffrey M
authors: JM
authors: Clarke
authors: Robert
authors: R
authors: Riffenburgh
authors: Higinia R
authors: HR
authors: Cardenes
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004379:Duodenal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012189:Retrospective Studies