PRIMARY ADENOCARCINOMA OF THE DUODENUM - TREATMENT AND SURVIVAL IN 89PATIENTS

Background/Aims: Primary adenocarcinoma of the duodenum is a rare dise ase and diagnosis is always late in being confirmed because of the non -specific symptoms, consequently leading to poor prognosis. Methodolog y: A retrospective review of 89 patients with non-ampullary duodenal a denocarcinoma treated in 36 different surgical departments in Italy be tween 1980 and 1994 was performed. The signs and symptoms, diagnostic studies conducted, tumor locations, surgical treatment, and survival w ere analyzed. Results: Duodenography and endoscopy were the most effec tive diagnostic tests, showing an accuracy of 81.9% and 88%, respectiv ely. The most common tumor site was periampullary, observed in 62.9% o f the cases. A curative resection was performed in 65 of the 89 patien ts (73%), a partial pancreatoduodenectomy in 37, a segmentary duodenal resection in 15 and a wide local excision in 11. The postoperative mo rtality rate was 10.1% (9 patients), and the overall 5-year survival w as 25%, which was significantly better after resection. The most impor tant prognostic factors were stage and tumor location. Conclusion: Ear ly diagnosis of primary duodenal adenocarcinoma is the only way to imp rove the results, by providing a higher resectability rate.