15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas
Background The aim of our study was to compare the outcomes of periampullary and extra-ampullary duodenal adenocarcinomas and segmental duodenal resection versus pancreatoduodenectomy and to evaluate prognostic factors. Methods We performed a retrospective review of all adults treated for duodenal a...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2012-04, Vol.16 (4), p.682-691 |
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| creator | Onkendi, Edwin O. Boostrom, Sarah Y. Sarr, Michael G. Farnell, Michael B. Nagorney, David M. Donohue, John H. Kendrick, Michael L. Reid-Lombardo, Kaye M. Harmsen, William S. Que, Florencia G. |
| description | Background
The aim of our study was to compare the outcomes of periampullary and extra-ampullary duodenal adenocarcinomas and segmental duodenal resection versus pancreatoduodenectomy and to evaluate prognostic factors.
Methods
We performed a retrospective review of all adults treated for duodenal adenocarcinoma by operative resection at a large tertiary referral center from 1994 to 2009.
Results
One hundred twenty-four patients had an operation for duodenal adenocarcinoma over a 15-year period (periampullary,
n
= 25, and extra-ampullary,
n
= 99). Ninety-nine patients (80%) underwent curative resection, including 24 (96%) with periampullary and 75 (76%) with extra-ampullary carcinomas. The average number of lymph nodes sampled was eight with segmental resection and 12 with pancreatoduodenectomy (
p
|
| doi_str_mv | 10.1007/s11605-011-1808-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_929507465</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2785300091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c371t-b531e1ccbaf51b18585615392fb72e4847c0b4cac53ea4f300c41f0bf1c7ff643</originalsourceid><addsrcrecordid>eNp1kdtKHTEUhoO0eGofwJsS6IVX0axMMpnxTrZHECxUwV6FTPaKjuyZTJMZPLxAX9tstkqx9Coh-daXlfUTsgN8DzjX-wmg5IpxAAYVr9jzGtmEShdMlqL8lPe8BiaUutkgWyndcw6aQ7VONoQoFNcCNskfUOwX2kiPHweMLfYO6UM73tGfU7xtnV3Qq4h27LAfafD0aApz7PPpzEbX9qGzB9TSWegGG9sU-iXzI3tsN0yLhY1P1Pbz7B6jZYfvZ_9a0hfy2dtFwq-v6za5Pjm-mp2xi8vT89nhBXOFhpE1qgAE5xrrFTRQqUqVoIpa-EYLlJXUjjfSWacKtNIXnDsJnjcenPa-lMU22V15hxh-T5hG07XJYe6rxzAlU4s6T0aWKpPfP5D3YYq562TyXFWpZK15pmBFuRhSiujNENsufzJDZhmSWYVkckhmGZJ5zjXfXs1T0-H8veItlQyIFZDyVX-L8e-n_2d9ATDUnjA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1095654970</pqid></control><display><type>article</type><title>15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Onkendi, Edwin O. ; Boostrom, Sarah Y. ; Sarr, Michael G. ; Farnell, Michael B. ; Nagorney, David M. ; Donohue, John H. ; Kendrick, Michael L. ; Reid-Lombardo, Kaye M. ; Harmsen, William S. ; Que, Florencia G.</creator><creatorcontrib>Onkendi, Edwin O. ; Boostrom, Sarah Y. ; Sarr, Michael G. ; Farnell, Michael B. ; Nagorney, David M. ; Donohue, John H. ; Kendrick, Michael L. ; Reid-Lombardo, Kaye M. ; Harmsen, William S. ; Que, Florencia G.</creatorcontrib><description>Background
The aim of our study was to compare the outcomes of periampullary and extra-ampullary duodenal adenocarcinomas and segmental duodenal resection versus pancreatoduodenectomy and to evaluate prognostic factors.
Methods
We performed a retrospective review of all adults treated for duodenal adenocarcinoma by operative resection at a large tertiary referral center from 1994 to 2009.
Results
One hundred twenty-four patients had an operation for duodenal adenocarcinoma over a 15-year period (periampullary,
n
= 25, and extra-ampullary,
n
= 99). Ninety-nine patients (80%) underwent curative resection, including 24 (96%) with periampullary and 75 (76%) with extra-ampullary carcinomas. The average number of lymph nodes sampled was eight with segmental resection and 12 with pancreatoduodenectomy (
p
< 0.001). Five-year overall survivals were 37% for the entire cohort (
n
= 124), 37% in the extra-ampullary group, and 38% in the periampullary group. Tumor size (
p
= 0.20), positive nodes (
p
= 0.60), segmental resection versus pancreatoduodenectomy (
p
= 0.55), adjuvant therapy (
p
= 0.23), and R
1
versus R
0
resection (
p
= 0.21) were not associated with survival. In contrast, advanced T stage and pathologic grade were associated with poor survival.
Conclusion
Extra-ampullary and periampullary duodenal adenocarcinomas have similar survival after resection. For distal duodenal tumors, survival is improved by curative resection without being compromised by limited resection. The number of lymph nodes sampled was significantly less with segmental resection than pancreatoduodenectomy.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-011-1808-z</identifier><identifier>PMID: 22350721</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>2011 SSAT Quick Shot ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater - pathology ; Ampulla of Vater - surgery ; Cancer ; Common Bile Duct Neoplasms - pathology ; Common Bile Duct Neoplasms - surgery ; Confidence intervals ; Duodenal Neoplasms - pathology ; Duodenal Neoplasms - surgery ; Female ; Fistula ; Gastroenterology ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Lymphatic system ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neoplasm Grading ; Neoplasm Recurrence, Local - etiology ; Neoplasm Staging ; Pancreaticoduodenectomy ; Patients ; Proportional Hazards Models ; Retrospective Studies ; Small intestine ; Surgery ; Treatment Outcome ; Tumor Burden ; Tumors</subject><ispartof>Journal of gastrointestinal surgery, 2012-04, Vol.16 (4), p.682-691</ispartof><rights>The Society for Surgery of the Alimentary Tract 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-b531e1ccbaf51b18585615392fb72e4847c0b4cac53ea4f300c41f0bf1c7ff643</citedby><cites>FETCH-LOGICAL-c371t-b531e1ccbaf51b18585615392fb72e4847c0b4cac53ea4f300c41f0bf1c7ff643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-011-1808-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-011-1808-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22350721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Onkendi, Edwin O.</creatorcontrib><creatorcontrib>Boostrom, Sarah Y.</creatorcontrib><creatorcontrib>Sarr, Michael G.</creatorcontrib><creatorcontrib>Farnell, Michael B.</creatorcontrib><creatorcontrib>Nagorney, David M.</creatorcontrib><creatorcontrib>Donohue, John H.</creatorcontrib><creatorcontrib>Kendrick, Michael L.</creatorcontrib><creatorcontrib>Reid-Lombardo, Kaye M.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Que, Florencia G.</creatorcontrib><title>15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
The aim of our study was to compare the outcomes of periampullary and extra-ampullary duodenal adenocarcinomas and segmental duodenal resection versus pancreatoduodenectomy and to evaluate prognostic factors.
Methods
We performed a retrospective review of all adults treated for duodenal adenocarcinoma by operative resection at a large tertiary referral center from 1994 to 2009.
Results
One hundred twenty-four patients had an operation for duodenal adenocarcinoma over a 15-year period (periampullary,
n
= 25, and extra-ampullary,
n
= 99). Ninety-nine patients (80%) underwent curative resection, including 24 (96%) with periampullary and 75 (76%) with extra-ampullary carcinomas. The average number of lymph nodes sampled was eight with segmental resection and 12 with pancreatoduodenectomy (
p
< 0.001). Five-year overall survivals were 37% for the entire cohort (
n
= 124), 37% in the extra-ampullary group, and 38% in the periampullary group. Tumor size (
p
= 0.20), positive nodes (
p
= 0.60), segmental resection versus pancreatoduodenectomy (
p
= 0.55), adjuvant therapy (
p
= 0.23), and R
1
versus R
0
resection (
p
= 0.21) were not associated with survival. In contrast, advanced T stage and pathologic grade were associated with poor survival.
Conclusion
Extra-ampullary and periampullary duodenal adenocarcinomas have similar survival after resection. For distal duodenal tumors, survival is improved by curative resection without being compromised by limited resection. The number of lymph nodes sampled was significantly less with segmental resection than pancreatoduodenectomy.</description><subject>2011 SSAT Quick Shot</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ampulla of Vater - pathology</subject><subject>Ampulla of Vater - surgery</subject><subject>Cancer</subject><subject>Common Bile Duct Neoplasms - pathology</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>Confidence intervals</subject><subject>Duodenal Neoplasms - pathology</subject><subject>Duodenal Neoplasms - surgery</subject><subject>Female</subject><subject>Fistula</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Neoplasm Staging</subject><subject>Pancreaticoduodenectomy</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Small intestine</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kdtKHTEUhoO0eGofwJsS6IVX0axMMpnxTrZHECxUwV6FTPaKjuyZTJMZPLxAX9tstkqx9Coh-daXlfUTsgN8DzjX-wmg5IpxAAYVr9jzGtmEShdMlqL8lPe8BiaUutkgWyndcw6aQ7VONoQoFNcCNskfUOwX2kiPHweMLfYO6UM73tGfU7xtnV3Qq4h27LAfafD0aApz7PPpzEbX9qGzB9TSWegGG9sU-iXzI3tsN0yLhY1P1Pbz7B6jZYfvZ_9a0hfy2dtFwq-v6za5Pjm-mp2xi8vT89nhBXOFhpE1qgAE5xrrFTRQqUqVoIpa-EYLlJXUjjfSWacKtNIXnDsJnjcenPa-lMU22V15hxh-T5hG07XJYe6rxzAlU4s6T0aWKpPfP5D3YYq562TyXFWpZK15pmBFuRhSiujNENsufzJDZhmSWYVkckhmGZJ5zjXfXs1T0-H8veItlQyIFZDyVX-L8e-n_2d9ATDUnjA</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Onkendi, Edwin O.</creator><creator>Boostrom, Sarah Y.</creator><creator>Sarr, Michael G.</creator><creator>Farnell, Michael B.</creator><creator>Nagorney, David M.</creator><creator>Donohue, John H.</creator><creator>Kendrick, Michael L.</creator><creator>Reid-Lombardo, Kaye M.</creator><creator>Harmsen, William S.</creator><creator>Que, Florencia G.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120401</creationdate><title>15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas</title><author>Onkendi, Edwin O. ; Boostrom, Sarah Y. ; Sarr, Michael G. ; Farnell, Michael B. ; Nagorney, David M. ; Donohue, John H. ; Kendrick, Michael L. ; Reid-Lombardo, Kaye M. ; Harmsen, William S. ; Que, Florencia G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-b531e1ccbaf51b18585615392fb72e4847c0b4cac53ea4f300c41f0bf1c7ff643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>2011 SSAT Quick Shot</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ampulla of Vater - pathology</topic><topic>Ampulla of Vater - surgery</topic><topic>Cancer</topic><topic>Common Bile Duct Neoplasms - pathology</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>Confidence intervals</topic><topic>Duodenal Neoplasms - pathology</topic><topic>Duodenal Neoplasms - surgery</topic><topic>Female</topic><topic>Fistula</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Neoplasm Staging</topic><topic>Pancreaticoduodenectomy</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Small intestine</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Onkendi, Edwin O.</creatorcontrib><creatorcontrib>Boostrom, Sarah Y.</creatorcontrib><creatorcontrib>Sarr, Michael G.</creatorcontrib><creatorcontrib>Farnell, Michael B.</creatorcontrib><creatorcontrib>Nagorney, David M.</creatorcontrib><creatorcontrib>Donohue, John H.</creatorcontrib><creatorcontrib>Kendrick, Michael L.</creatorcontrib><creatorcontrib>Reid-Lombardo, Kaye M.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Que, Florencia G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Onkendi, Edwin O.</au><au>Boostrom, Sarah Y.</au><au>Sarr, Michael G.</au><au>Farnell, Michael B.</au><au>Nagorney, David M.</au><au>Donohue, John H.</au><au>Kendrick, Michael L.</au><au>Reid-Lombardo, Kaye M.</au><au>Harmsen, William S.</au><au>Que, Florencia G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>16</volume><issue>4</issue><spage>682</spage><epage>691</epage><pages>682-691</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
The aim of our study was to compare the outcomes of periampullary and extra-ampullary duodenal adenocarcinomas and segmental duodenal resection versus pancreatoduodenectomy and to evaluate prognostic factors.
Methods
We performed a retrospective review of all adults treated for duodenal adenocarcinoma by operative resection at a large tertiary referral center from 1994 to 2009.
Results
One hundred twenty-four patients had an operation for duodenal adenocarcinoma over a 15-year period (periampullary,
n
= 25, and extra-ampullary,
n
= 99). Ninety-nine patients (80%) underwent curative resection, including 24 (96%) with periampullary and 75 (76%) with extra-ampullary carcinomas. The average number of lymph nodes sampled was eight with segmental resection and 12 with pancreatoduodenectomy (
p
< 0.001). Five-year overall survivals were 37% for the entire cohort (
n
= 124), 37% in the extra-ampullary group, and 38% in the periampullary group. Tumor size (
p
= 0.20), positive nodes (
p
= 0.60), segmental resection versus pancreatoduodenectomy (
p
= 0.55), adjuvant therapy (
p
= 0.23), and R
1
versus R
0
resection (
p
= 0.21) were not associated with survival. In contrast, advanced T stage and pathologic grade were associated with poor survival.
Conclusion
Extra-ampullary and periampullary duodenal adenocarcinomas have similar survival after resection. For distal duodenal tumors, survival is improved by curative resection without being compromised by limited resection. The number of lymph nodes sampled was significantly less with segmental resection than pancreatoduodenectomy.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22350721</pmid><doi>10.1007/s11605-011-1808-z</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2012-04, Vol.16 (4), p.682-691 |
| issn | 1091-255X 1873-4626 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_929507465 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | 2011 SSAT Quick Shot Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Ampulla of Vater - pathology Ampulla of Vater - surgery Cancer Common Bile Duct Neoplasms - pathology Common Bile Duct Neoplasms - surgery Confidence intervals Duodenal Neoplasms - pathology Duodenal Neoplasms - surgery Female Fistula Gastroenterology Humans Kaplan-Meier Estimate Lymphatic Metastasis Lymphatic system Male Medical prognosis Medicine Medicine & Public Health Middle Aged Mortality Neoplasm Grading Neoplasm Recurrence, Local - etiology Neoplasm Staging Pancreaticoduodenectomy Patients Proportional Hazards Models Retrospective Studies Small intestine Surgery Treatment Outcome Tumor Burden Tumors |
| title | 15-Year Experience with Surgical Treatment of Duodenal Carcinoma: a Comparison of Periampullary and Extra-Ampullary Duodenal Carcinomas |
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