Clinicopathological Review of 62 Cases of Primary Duodenal Adenocarcinoma
Maryam J Zenali, Michael Overman, Asif Rashid, Stanley R Hamilton, Russell Broaddus, Matthew H Katz, James L Abbruzzese, Jason B Fleming, Wang Huamin. The University of Texas MD Anderson Cancer Center, Houston, TX
Background: Primary duodenal adenocarcinoma (PDuA) is uncommon, and the clinicopathologic features and prognostic factors in patients with PDuA are unclear.
Design: We reviewed sixty-two cases of PDuA who underwent surgical resection for PDuA at our institution. The archival H & E stained slides were reviewed. Patient clinical and follow-up information was extracted from patient medical records or review of the U.S. Social Security Index. Statistical analysis was performed using Statistical Package for Social Sciences software with two-sided significance level of 0.05 for all statistical analyses.
Results: Our patient population consisted of 31 males and 31 females with age ranging from 35 to 88 years (median: 59 years). 48 patients underwent pancreaticoduodenectomy, 13 patients underwent segmental duodenal resection and one underwent transduodenal polypectomy. The tumor size ranged from 0.3 to 7.4 cm (median: 3.5 cm). Adenoma was present in 37% (23/62) of the cases. Well, moderate and poorly differentiated adenocarcinomas were present in 3, 42 and 17 patients, respectively. Ten cases (16%) showed mucinous differentiation. 4, 12, 27 and 19 patients had T1, T2, T3, and T4 tumor respectively with lymph node metastasis identified in 31/59 (53%) patients who underwent lymphadenectomy. Stage I, II, II and IV disease was present in 4 (6.5%), 23 (37%), 31 (50%), and 4 (6.5%) of patients respectively. The follow-up information was available in 59 patients (range: 6 to 222 months, median: 111 months). During follow-up, metastasis to liver, lung, retroperitoneum, skin and local recurrence were detected in 4, 3, 4, 1 and 7 patients respectively. The median survival was 111 ± 39 months. Lymph node metastasis and AJCC stage correlated significantly with patient survival (P<0.05). No significant correlation between survival and other pathological parameters was observed.
Conclusions: Our study show that patients with PDuA who underwent surgical resection have a good prognosis.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 73, Wednesday Morning