Clinicopathological characteristics and survival analysis of primary duodenal cancers: a 14-year experience in a tertiary centre in South China

Abstract

Background: Primary duodenal cancer (PDC) is rare and few studies have addressed it adequately, especially in China. The present study is to evaluate the clinicopathological features and prognosis of PDC in Chinese patients.

Patients and methods: All the consecutive cases confirmed as PDC by histopathological analysis in The First Affiliated Hospital of Sun Yat-sen University between 1995 and 2008 were included. Clinicopathological details were retrospectively analysed and prognostic factors influencing survival were evaluated.

Results: The patient cohort included 53 men and 38 women, accounting for only 0.02% of all in-patients during this period. Esophagogastroduodenoscopy and gastrointestinal barium radiography were mainstay diagnostic tests for PDC; they detected 88.6% and 83.3% of the tumours, respectively. Tumours mainly occurred in the descending portion of the duodenum (67.0%). Abdominal pain was the most frequent symptom (56.0%). Histologically, adenocarcinoma was the most common type (74.7%). The overall 1-, 3- and 5-year survival rates were 62.6%, 43.7% and 33.1%, respectively. Patients survived longer in the curative surgery group (median survival time of 45 months) than those in the palliative group (6 months) (P < 0.001). Nodal metastasis and positive resection margin had a significant negative impact on survival in patients undergoing potentially curative surgery in a univariate and multivariate model (P < 0.05).

Conclusion: Patients with PDC are rare and lack specific presentations. Esophagogastroduodenoscopy and gastrointestinal barium radiography are effective in screening this rare tumour. Nodal metastasis and positive resection margins are associated with a poor prognosis. A curative surgery that achieves complete resection with negative margin should be pursued.