Primary adenocarcinoma of third and fourth portions of duodenum. Favorable prognosis after resection
J. A. Lowell, R. L. Rossi, J. L. Munson and J. W. Braasch
Department of General Surgery, Lahey Clinic Medical Center, Burlington, Mass 01805.
Duodenal adenocarcinoma, a rare malignant lesion, is associated with a poor
5-year survival. Few series have addressed differences between resectable
tumors of the proximal and distal duodenum. We reviewed records of 17
consecutive patients with adenocarcinoma of the duodenum who underwent
resection: 10 had adenocarcinoma of the proximal duodenum, and seven had
tumors of the distal duodenum. Most patients underwent
pancreatoduodenectomy. Five patients with adenocarcinoma of the distal
duodenum underwent segmental resection. No perioperative deaths occurred.
Six of 10 patients with proximal tumors died of metastatic disease. Of the
seven patients with tumors of the distal duodenum, five are alive without
evidence of disease, and two died of unrelated causes. The survival of
patients with adenocarcinoma of the distal duodenum is surprisingly good,
and segmental resection is the procedure of choice.
