Prognostic Impact of Pancreatic Invasion in Duodenal Carcinoma: A Single-Center Experience
- PDF / 459,988 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 45 Downloads / 184 Views
ORIGINAL ARTICLE – PANCREATIC TUMORS
Prognostic Impact of Pancreatic Invasion in Duodenal Carcinoma: A Single-Center Experience Nobuhito Nitta1, Katsuhisa Ohgi1 , Teiichi Sugiura1, Yukiyasu Okamura1, Takaaki Ito1, Yusuke Yamamoto1, Ryo Ashida1, Keiko Sasaki2, and Katsuhiko Uesaka1 1
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan; 2Division of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan
ABSTRACT Background. The prognostic factors for duodenal carcinoma (DC) remain unclear because of its rarity. This study aimed to investigate the prognostic impact of pancreatic invasion (PI) on postoperative survival for patients with DC. Methods. This study retrospectively analyzed 86 patients with DC, including 18 patients with PI, who underwent surgical resection between October 2002 and March 2018. The clinicopathologic features and survival outcomes of these patients were investigated to identify the prognostic factors in DC. The long-term survival for the DC patients with PI was compared with that for the patients who underwent resection for resectable pancreatic head carcinoma (RPHC) during the same period. Results. The median survival time (MST) for the DC patients with PI was 25.7 months, which was significantly worse than for the patients with T2 or deeper DC without PI (p = 0.010). The multivariate analysis showed that the independent prognostic factors were PI (hazard ratio [HR] 7.59; p = 0.019) and lymph node metastasis (LNM) (HR 5.01; p = 0.026). The MST for the DC patients with PI did not differ significantly from that for the RPHC patients treated without adjuvant chemotherapy (p = 0.135). Comparable rates of microscopic venous invasion and hematogenous metastasis were observed for the DC patients with PI and the RPHC patients.
Ó Society of Surgical Oncology 2020 First Received: 10 December 2019 K. Ohgi e-mail: [email protected]
Conclusions. Pancreatic invasion was an independent prognostic factor in DC. The survival outcomes for the DC patients with PI did not differ from those for the patients with RPHC, which was associated with a high rate of hematogenous recurrence.
Duodenal carcinoma (DC), except for ampullary carcinoma, is the most common carcinoma originating from the small intestine and accounts for about 50% of the small intestinal carcinoma cases.1 Although the incidence of DC has been increasing in recent years,2 it remains an uncommon tumor, accounting for less than 1% of all gastrointestinal malignancies.3 Surgical resection is the only potentially curative treatment for DC,4 but the survival outcome has been undesirable.5,6 An association between various pathologic factors and survival has been unclarified,5,7,8 and strong evidence supporting the utility of adjuvant chemotherapy (ACT) remains elusive due to the rarity of DC.8,9 Some previous studies have investigated both the relative survival and histopathologic features of periampullary malignancies.10,11 Pancreatic carcinoma has the worst survival due to its higher incidences of lymph
Data Loading...
