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Clinicopathological characteristics and survival analysis of primary duodenal cancers: a 14-year experience in a tertiary centre in South China

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Abstract

Background

Primary duodenal cancer (PDC) is rare and few studies have addressed it adequately, especially in China. The present study is to evaluate the clinicopathological features and prognosis of PDC in Chinese patients.

Patients and methods

All the consecutive cases confirmed as PDC by histopathological analysis in The First Affiliated Hospital of Sun Yat-sen University between 1995 and 2008 were included. Clinicopathological details were retrospectively analysed and prognostic factors influencing survival were evaluated.

Results

The patient cohort included 53 men and 38 women, accounting for only 0.02% of all in-patients during this period. Esophagogastroduodenoscopy and gastrointestinal barium radiography were mainstay diagnostic tests for PDC; they detected 88.6% and 83.3% of the tumours, respectively. Tumours mainly occurred in the descending portion of the duodenum (67.0%). Abdominal pain was the most frequent symptom (56.0%). Histologically, adenocarcinoma was the most common type (74.7%). The overall 1-, 3- and 5-year survival rates were 62.6%, 43.7% and 33.1%, respectively. Patients survived longer in the curative surgery group (median survival time of 45 months) than those in the palliative group (6 months) (P < 0.001). Nodal metastasis and positive resection margin had a significant negative impact on survival in patients undergoing potentially curative surgery in a univariate and multivariate model (P < 0.05).

Conclusion

Patients with PDC are rare and lack specific presentations. Esophagogastroduodenoscopy and gastrointestinal barium radiography are effective in screening this rare tumour. Nodal metastasis and positive resection margins are associated with a poor prognosis. A curative surgery that achieves complete resection with negative margin should be pursued.

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Acknowledgements

The authors greatly thank Dr Brandon Steelman from Stanford University, Tracy Zhu from Chinese University of Hong Kong and Mr Steven Lee from Indiana University–Purdue University Indianapolis for their kind critical reading and linguistic revisions of the manuscript. We thank Dr Zijin Weng and Prof. Yu Tao from Division of Pathology of Sun Yat-sen University for helpful suggestions on the pathological typing and skilful technical assistance. We also thank Prof. Yuantao Hao from Department of Statistics and Epidemiology, Sun Yat-sen University for his kind help on statistics. In addition, we appreciate all the doctors and students for their great work in building the gastrointestinal tumour database.

Conflicts of interest

None.

Funding source

This study is sponsored by Science and Technology Foundation of Guangdong Province (no. 2008B030301298, 2009B030801174), Yat-sen innovative talents’ training program of outstanding supervisor of Sun Yat-sen University and International Program Fund of 985 Project of Sun Yat-sen University.

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Authors and Affiliations

  1. Division of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, Guangdong Province, People’s Republic of China

    Shenghong Zhang, Yi Cui, Bihui Zhong, Xiaorong Gong, Kang Chao & Minhu Chen

  2. Division of Radiation Oncology, Cancer Center of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Weiwei Xiao

  3. State Key Laboratory of Oncology in South China, Guangzhou, 510080, People’s Republic of China

    Weiwei Xiao

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  1. Shenghong Zhang
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  2. Yi Cui
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  3. Bihui Zhong
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  4. Weiwei Xiao
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  5. Xiaorong Gong
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  7. Minhu Chen
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Corresponding author

Correspondence to Minhu Chen.

Additional information

Presentation of meeting: The abstract of this article was accepted as poster presentation by the meeting of GASTRO 2009, UEGW/WCOG in London.

Shenghong Zhang and Yi Cui have contributed equally to the work.

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Zhang, S., Cui, Y., Zhong, B. et al. Clinicopathological characteristics and survival analysis of primary duodenal cancers: a 14-year experience in a tertiary centre in South China. Int J Colorectal Dis 26, 219–226 (2011). https://doi.org/10.1007/s00384-010-1063-x

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  • DOI: https://doi.org/10.1007/s00384-010-1063-x

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