Primary Duodenal Adenocarcinoma

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Abstract
PRIMARY adenocardinoma of the duodenum is a rare disease with a poorly defined natural history. It represents less than 0.5% of all gastrointestinal tract malignant neoplasms and accounts for up to 45% of small bowel cancers.1-5 The disease is usually diagnosed at an advanced stage, but reported 5-year survivals range up to 50%.1,6-10 Surgical resection is the only potentially curative treatment, but not all patients from whom the tumor is removed necessarily survive long-term. Because of the small number of patients with this neoplasm, it has been difficult to determine those factors that influence survival. Controversial issues include the significance of the tumor stage and degree of differentiation, and the prognostic value of nodal status. The importance of the location of the tumor in the duodenum, as well as the type of surgical resection performed have also been debated. All of the published experience to date has come from retrospective reviews, and most have covered a period of 20 years or less, with correspondingly small sample sizes. In the present retrospective study, we have analyzed the factors associated with survival in our 40-year experience with primary duodenal adenocarcinoma.

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