Prognostic Factors and Clinical Characteristics of Patients with Primary Duodenal Adenocarcinoma: A Single-Center Experience from China

Jiang, Qinglong; Huang, Xiao Ping; Chen, Yingtai; Zhang, Jianwei; Wang, Chengfeng

doi:10.1155/2016/6491049

Cited by 33 publications

(44 citation statements)

References 20 publications

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“…2 b). 12 , 31 , 32 , 34 , 36 , 37 , 41 , 42 , 44 – 46 Lymph node involvement remained an independent prognostic factor in most studies after correction for other clinicopathological factors, including tumor size, differentiation grade, and disease stage. 12 , 24 , 31 , 34 , 37 , 41 , 42 , 45 , 46 …”

Section: Resultsmentioning

confidence: 97%

“…A total of eight studies, comparing survival of patients treated with either pancreaticoduodenectomy or segmental resection, were eligible for comparison. 10 – 12 , 22 , 32 , 34 , 39 , 43 All these studies reported no significant differences in survival comparing segmental resection with pancreaticoduodenectomy. Two studies reported a greater number of lymph nodes sampled and more positive lymph nodes removed in patients undergoing pancreaticoduodenectomy, compared with segmental resection.…”

Section: Resultsmentioning

confidence: 97%

“…CRTx, adj. CTx M, OS-5 – – – – – Han 10 32 1990–2006 RCS China 56 (7) 19 (59) 106 CR, PT OS-1,3,5 2 8 17 5 6 Hung 33 23 1994–2005 RCS Taiwan 68 (12) 15 (65) 15.1 CR, PT M, OS-1,3,5 9 14 – – – Hurtuk 44 52 1984–2005 RCS USA 65 (12) 36 (69) 24 CR, PT M, OS-3,5 – – – – – Jiang 34 201 1999–2015 RCS China 55 (10) 78 (61) b 20 CR, PT M, OS-1,3,5 5 113 9 …”

Section: Resultsmentioning

confidence: 99%

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Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

et al. 2018

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BackgroundDuodenal adenocarcinoma (DA) is a rare tumor for which survival data per treatment modality and disease stage are unclear. This systematic review and meta-analysis aims to summarize the current literature on patient outcome after surgical, (neo)adjuvant, and palliative treatment in patients with DA.MethodsA systematic search was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines, to 25 April 2017. Primary outcome was overall survival (OS), specified for treatment strategy or disease stage. Random-effects models were used for the calculation of pooled odds ratios per treatment modality. Included papers were also screened for prognostic factors.ResultsA total of 26 observational studies, comprising 6438 patients with DA, were included. Of these, resection with curative intent was performed in 71% (range 53–100%) of patients, and 29% received palliative treatment (range 0–61%). The pooled 5-year OS rate was 46% after curative resection, compared with 1% in palliative-treated patients (OR 0.04, 95% confidence interval [CI] 0.02–0.09, p < 0.0001). Both segmental resection and pancreaticoduodenectomy allowed adequate assessment of lymph node involvement and resulted in similar OS. Lymph node involvement correlated with worse OS (pooled 5-year survival rate 21% for nodal metastases vs. 65% for node-negative disease; OR 0.17, 95% CI 0.11–0.27, p < 0.0001). In the current literature, no survival benefit for adjuvant therapy after curative resection was found.ConclusionResection with curative intent, either pancreaticoduodenectomy or segmental resection, and lack of nodal metastases, favors survival for DA. Further studies exploring multimodality (neo)adjuvant therapy are warranted to investigate their benefit.Electronic supplementary materialThe online version of this article (10.1245/s10434-018-6567-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

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Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

et al. 2018

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“…Qing-Long Jiang et al . revealed that LN metastasis and vascular invasion were independent prognostic factors that were negatively associated with survival in patients undergoing curative resection 21 . In this study, through univariable analysis and subsequent multivariable Cox regression analysis, we identified patients with elder age, worse tumor grade and advanced TNM stage had shorter CSS.…”

Section: Discussionmentioning

confidence: 96%

Prognosis and nomogram for predicting postoperative survival of duodenal adenocarcinoma: A retrospective study in China and the SEER database

Jiang

Zhao

et al. 2018

Sci Rep

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As primary duodenal adenocarcinoma is rare, the prognostic factors of this disease remain insufficiently explored, especially in China. We identified postoperative duodenal adenocarcinoma patients at a Chinese double-center (from 2006 to 2016) or who were registered with the Surveillance, Epidemiology, and End Results (SEER) database (from 2004 to 2014). Clinicopathological features and significant prognostic factors for cancer-specific survival (CSS) were reviewed and analyzed by using univariate and multivariate Cox proportional hazards regression. Then, a nomogram predicting CSS was constructed based on the SEER database and validated externally by using the separate Chinese cohort. Totally, 137 patients from the Chinese double-center and 698 patients from the SEER database were included for analysis. The multivariate analyses showed that age, tumor grade and TNM stage were independent prognostic factors. The nomogram constructed using these factors showed a clear prognostic superiority to the AJCC-TNM classification, 7th ed. (C-index: SEER cohort, 0.693 vs 0.625, P < 0.001; Chinese cohort, 0.677 vs 0.659, P < 0.001, respectively). In summary, the valuable prognostic factors in patients with duodenal adenocarcinoma were age, tumor grade and TNM stage. This study developed a nomogram that can precisely predict the CSS for postoperative duodenal adenocarcinoma patients.

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“…The median overall survival(OS) of metastatic duodenum adenocarcinoma, ranging from 2 to 8 months, is much worse than advanced colorectal cancer 4 . Various studies have attempted to evaluate different prognostic factors for primary duodenum adenocarcinoma, and some studies have identified the T stage, nodal metastasis, pathologic grade, lymphovascular invasion, age, weight loss and perineural invasion as prognostic factors 5 - 12 . Due to the rare incidence, the number of patients in previous studies was relatively small, with a range from 17 to 178 patients 5 - 12 .…”

Section: Introductionmentioning

confidence: 99%

Elevated baseline serum lactate dehydrogenase indicates a poor prognosis in primary duodenum adenocarcinoma patients

Chen

Qiu

et al. 2018

J. Cancer

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Purpose: Tumour cells produce energy through glycolysis and lactate dehydrogenase (LDH) is a key part of glycolysis. Elevation of serum LDH may indicate poor prognosis in primary duodenum adenocarcinoma. We aim to explore the prognostic significance of LDH in this disease.Methods and materials: Two hundred forty-four patients diagnosed with primary duodenum adenocarcinoma who were treated at the Sun Yat-sen Cancer Center from February 1996 to January 2016 were retrospectively analysed. We collected routine clinical data, including baseline LDH. Patients were classified into a normal LDH group (≤ 245U/L) and higher LDH group (>245U/L). Correlations of the LDH level and other clinicopathological characteristics were explored using the Chi-square test. Prognostic factors for overall survival were identified using univariate and multivariate analyses.Results: Two hundred seven patients (84.9%) had normal LDH levels, while 37 patients (15.1%) had abnormally high LDH levels. Higher LDH levels were significantly associated with more distant metastasis, node metastasis, poor differentiation and TNM stage Ⅲ-Ⅳ (P<0.05). Consistently, patients with node metastasis, poor differentiation and TNM stageⅢ-Ⅳ had a significantly higher median LDH level (P<0.05). The median survival of patients in the higher LDH group was significantly shorter than that of the patients in the normal LDH group (16.3 m vs. 42.5 m, P=0.02). Using multivariate analysis, LDH, age and radical surgery were independent prognostic factors associated with overall survival(OS) (HR=1.571, P=0.036 for LDH; HR=1.514, P=0.013 for age; HR=0.248, P<0.0001 for radical surgery, respectively).Conclusions: For the first time, our research suggests that baseline serum LDH is an independent prognostic factor in primary duodenum adenocarcinoma patients and elevated baseline serum LDH indicates a poor prognosis.

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Prognostic Factors and Clinical Characteristics of Patients with Primary Duodenal Adenocarcinoma: A Single-Center Experience from China

Cited by 33 publications

References 20 publications

Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

Prognosis and nomogram for predicting postoperative survival of duodenal adenocarcinoma: A retrospective study in China and the SEER database

Elevated baseline serum lactate dehydrogenase indicates a poor prognosis in primary duodenum adenocarcinoma patients

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