Clinicopathological features and surgery-related outcomes of duodenal adenocarcinoma: a multicenter retrospective study
10.3760/cma.j.cn112152-20250120-00030
- VernacularTitle:十二指肠腺癌临床病理特征和手术相关预后的多中心回顾性研究
- Author:
Qifeng XIAO
1
;
Xin WU
;
Chunhui YUAN
;
Zongting GU
;
Xiaolong TANG
;
Fanbin MENG
;
Dong WANG
;
Ren LANG
;
Gang ZHAI
;
Xiaodong TIAN
;
Yu ZHANG
;
Enhong ZHAO
;
Xiaodong ZHAO
;
Feng CAO
;
Jingyong XU
;
Ying XING
;
Jishu WEI
;
Shanmiao GOU
;
Chengfeng WANG
;
Jianwei ZHANG
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院胰胃外科，北京 100021
- Publication Type:Journal Article
- Keywords:
Duodenum cancer;
Pancreatoduodenectomy;
Survival;
Risk factors
- From:
Chinese Journal of Oncology
2025;47(10):1026-1038
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.
