Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum.
OBJECTIVE
To evaluate the results of segmental duodenectomy (SD) and pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumor (GIST) and help clinicians with surgical management.


METHODS
All patients who underwent surgery for non-metastatic GIST of the duodenum in a single institution since 2000 were prospectively followed up. Seven patients (median age 51 years, range: 41-73 years) were enrolled: five underwent SD and two underwent PD.


RESULTS
All the patients had a complete resection (R0), with no postoperative morbidity and mortality. Among the SD group, GIST was classified as low risk in two patients, intermediate risk in two, and high risk in one, according to the Fletcher scale, (vs two high risk patients in the PD group). With a median follow-up of 41 (18-85) mo, disease-free survival (DFS) rates were 100% after SD and 0% after PD (P < 0.05). The median DFS was 13 mo in the PD group.


CONCLUSIONS
Whenever associated with clear surgical margins, SD is a reliable and curative option for most duodenal GISTs, and is compatible with long-term DFS.
Department of Surgery, University Hospital Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland. nicolas.c.buchs@hcuge.ch
Nicolas Christian
NC
Buchs
Pascal
P
Bucher
Pascal
P
Gervaz
Sandrine
S
Ostermann
François
F
Pugin
Philippe
P
Morel
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome