Primary Non-ampullary Duodenal Adenocarcinoma: A Single-center Experience for 15 Years.
10.4166/kjg.2015.66.4.194
- Author:
Hyun Seon YOU
1
;
Jeong Woo HONG
;
Eun Young YUN
;
Jin Joo KIM
;
Jae Min LEE
;
Sang Soo LEE
;
Hong Jun KIM
;
Chang Yoon HA
;
Hyun Jin KIM
;
Tae Hyo KIM
;
Woon Tae JUNG
;
Ok Jae LEE
Author Information
1. Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea. ojlee@gnu.ac.kr
- Publication Type:Case Reports ; English Abstract
- Keywords:
Dudenal cancer;
Adenocarcinoma;
Survival;
Prognosis
- MeSH:
Adenocarcinoma/*diagnosis/mortality/pathology;
Adult;
Aged;
Aged, 80 and over;
Bilirubin/blood;
Demography;
Duodenal Neoplasms/*diagnosis/mortality/pathology;
Female;
Gastroscopy;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Neoplasm Metastasis;
Neoplasm Recurrence, Local;
Neoplasm Staging;
Prognosis;
Retrospective Studies
- From:The Korean Journal of Gastroenterology
2015;66(4):194-201
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Primary non-ampullary duodenal adenocarcinomas (PNADAs) comprise <0.3% of gastrointestinal malignancies. The rarity of PNADA and poorly defined natural history often leads to a delayed correct diagnosis. This study was conducted to evaluate the clinical characteristics of PNADA and to identify its prognostic factors. METHODS: Data were collected by retrospectively reviewing the medical records of patients with PNADA managed at Gyeongsang National University Hospital from January 2000 to December 2014. Demographic, clinical, endoscopic, and pathological variables were investigated, and factors related to survival were analyzed. RESULTS: Twenty-seven patients with PNADA were identified, and their median age was 64.9+/-13.6 years with 16 (59.3%) being male. The majority of patients (25/27, 92.6%) were initially diagnosed during upper endoscopy with biopsies. The tumor was located on the 1st or 2nd portion of duodenum in 92.6% (25/27) of patients. At the time of diagnosis, 85.2% (23/27) had advanced diseases (stage III or IV); 48.2% (13/27) had distant metastasis. Median survival time was 12 months (1-93 months). One and 3-year survival rates were 48.1% and 33.3%, respectively. On multivariable analysis, total bilirubin > or =2 mg/dL (OR, 85.28; 95% CI, 3.77-1,938.79; p=0.005) and distant metastasis (OR, 26.74; 95% CI, 3.13-2,328.14; p=0.003) at the time of diagnosis were independent poor prognostic factors. CONCLUSIONS: The majority of patients were diagnosed at an advanced stage. Presence of distant metastasis was independent prognostic factor of PNADA together with elevated total bilirubin.
