Extent of resection in the management of duodenal adenocarcinoma

Kaklamanos, Ioannis; Bathe, Oliver F.; Franceschi, Dido; Camarda, Christina; Levi, Joé U.; Livingstone, Alan S.

doi:10.1016/s0002-9610(99)00269-x

Cited by 132 publications

(125 citation statements)

References 15 publications

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“…The median number of TLNs assessed (interquartile range [IQR]) according to disease stage was 1 (IQR, 0-7) for stage I, 4 (IQR, 0-9) for stage II, and 8 (IQR, 4-13) for stage III. In patients with stage II cancer who had at least 1 lymph node assessed, the median number of TLNs assessed (IQR) was 6 (IQR, [3][4][5][6][7][8][9][10][11][12]. The median number of TLNs accessed (IQR) in patients with stage II disease was lower in patients with duodenal cancers (median, 3; IQR, 0-9) than in patients with jejunal cancers (median, 5; IQR, 2-10; P ¼ .01) and patients with ileal cancers (median, 5; IQR, 2-12; P < .01).…”

Section: Clinicopathologic Characteristicsmentioning

confidence: 99%

Prognostic value of lymph node evaluation in small bowel adenocarcinoma

Overman

Wolff

et al. 2010

Cancer

104

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BACKGROUND:The presence of distant metastases and the completeness of resection are important prognostic factors in patients with small bowel adenocarcinoma (SBA); however, the influence of lymph node metastasis on patient outcome has not been well characterized. The objective of the current study was to evaluate the impact of the number of positive and negative lymph nodes on survival after curative resection. METHODS: Patients who had SBA diagnosed between 1988 and 2005 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry. Cox proportional hazards regression analyses were performed after adjusting for age, sex, race, tumor stage, tumor grade, and primary site. Five-year disease-specific survival (DSS) was determined, all patients were categorized according to the total lymph nodes (TLNs) assessed, and patients with stage III disease also were categorized according to the number of positive lymph nodes (PLNs) and the PLN-to-TLN ratio (the lymph node ratio [LNR]). RESULTS: In total, 1991 patients (n ¼ 1216 with stage I/II SBA and n ¼ 775 with stage III SBA) were analyzed. Survival depended on the TLNs assessed. The 5-year DSS rate for patients with stage II disease was associated with the TLNs assessed (44%, 69%, and 83% for 0 TLNs, 1-7 TLNs, and >7 TLNs, respectively). The 5-year DSS for patients with stage III disease was associated with the number of PLNs (58% and 37% for <3 PLNs and 3 PLNs, respectively). Among patients with stage III disease, the LNR was even more predictive of survival than stratification by the number of PLNs. CONCLUSIONS: Survival after surgical resection for stage I, II, and III SBA was associated with the TLNs assessed. Stratifying patients with stage III disease into those with <3 PLNs and 3 PLNs significantly improved prognostication. Cancer 2010;116:5374-82.

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Section: Clinicopathologic Characteristicsmentioning

confidence: 99%

Prognostic value of lymph node evaluation in small bowel adenocarcinoma

Overman

Wolff

et al. 2010

Cancer

104

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“…According to these reports, there are two kinds of surgery, three cases of pylorus preserving pancreatoduodenectomy and partial duodenectomy and eight cases of partial duodenectomy with lymphadenectomy. In Kaklamanos's report, there was no significant difference in prognosis between pancreatoduodenectomy and partial duodenectomy in 63 cases of primary duodenal adenocarcinoma [16]. In Lowell's report, the seven cases of primary duodenal adenocarcinoma of the third or fourth portions are all alive after five years, except for those who died of another disease [17].…”

Section: Discussionmentioning

confidence: 94%

“…In Japan, there are eleven case reports of primary duodenal adenocarcinoma of the fourth portion resected surgically, including our case [5][6][7][8][9][10][11][12][13][14][15][16] (Table 1). The median age was 60.5 years (range 42-74 years).…”

Section: Discussionmentioning

confidence: 99%

Primary duodenal adenocarcinoma of the fourth portion diagnosed using double-balloon enteroscopy and surgically resected: A case report

Kawano¹,

Sato²,

Maekawa³

et al. 2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: We report a rare case of primary duodenal adenocarcinoma of the fourth portion diagnosed by double-balloon enteroscopy and resected surgically. A 57-year-old male was anemic. Positron emission tomography -computed tomography revealed accumulation in the fourth portion of the duodenum. Double-balloon enteroscope showed circular tumor of the fourth portion of the duodenum, and biopsy disclosed poorly differentiated adenocarcinoma. Partial duodenectomy and partial colonectomy were performed. The marginal artery of the transverse colon was invaded. Histological examination disclosed that the tumor was poorly differentiated adenocarcinoma and two lymph node metastases were seen. Conclusion: Primary duodenal adenocarcinoma of fourth portion can be diagnosed by doubleballon enteroscopy and treated by surgical resection. IJCRI publishes Review

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“…Meanwhile, Maher et al and we used PSD to describe resection of only the third and fourth portions of the duodenum (7,11). This procedure has also been named segmental duodenectomy (12)(13)(14). Cho et al reported proximal segmental duodenectomy under the term PSD (15).…”

Section: Discussionmentioning

confidence: 99%