title: Radical surgical management of periampullary duodenal adenocarcinoma: a single institution experience.
abstract: OBJECTIVE
  To share a single-centre experience with radical resection of adenocarcinoma of the second part of duodenum.
  
  
  METHODS
  The retrospective review was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, and comprised data of patients who underwent pancreaticoduodenal resection for duodenal adenocarcinoma from January 1999 to December 2012. Patient characteristics and histopathological variables were assessed. Post-op complications, median disease-free span and overall survival were assessed. Expected 5-year disease-free and overall survival were calculated using Kaplan Meier curves.
  
  
  RESULTS
  Of the 12 patients whose records were included, 8 (66.6%) were men and 4 (33.33%) were women. Overall median age was 55 years (range: 38-70 years). Jaundice was the predominant symptom in 9 (75%) patients. Five complications were observed during the post-operative period. Median disease-free and overall survival was 14.5 (0-140) and 17.5 (1-140) months respectively. Expected 5-year disease-free and overall survival were 56% and 21% respectively. Patients who survived >24 months had underlying well differentiated tumours, negative surgical margins, absence of perineural invasion and pancreatic involvement.
  
  
  CONCLUSIONS
  Peri-ampullary duodenal adenocarcinoma is a rare malignancy. In selected patients, pancreatic oduodenectomy produces acceptable results.
authors.forename: Abu Bakar Hafeez
authors.initials: AB
authors.lastname: Bhatti
authors.forename: Muhammad Aasim
authors.initials: MA
authors.lastname: Yosuf
authors.forename: Aamir Ali
authors.initials: AA
authors.lastname: Syed
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D004379:Duodenal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D016896:Treatment Outcome