A Clinicopathological Study on Primary Carcinoma of the Duodenum

Gen Sugawara, Akihiro Yamaguchi, Masatoshi Isogai, Tohru Harada, Yuji Kaneoka, Masahiko Suzuki, Atsushi Akutagawa, Kiyoshi Suzumura and Tatsuya Usui

Department of Surgery, Ogaki Munincipal Hospital

The incidence of primary duodenal cancer is low among digestive tract cancers, but since it is often diagnosed a few considerable progression, prognosis is poor. We clinicopathologically examined for 20 patients undergoing resection for primary duodenal cancer. Pancreatoduodenectomy numbered 15, partial duodenal excision numbered 3, and pancreatoduodenectomy with preservation of the pyloric ring numbered 2 cases. Mural invasion into the pancreas was observed in 14 cases and metastasis to lymph nodes in 15. Cumulative 5-year survival was 30%. Statistical analysis revealed 4 prognotic indicators of the extent of mural invasion, metastasis to lymph nodes, histological classification, and invasion of veins. Pancreatoduodenectomy with preservation of the pyloric ring acompanied by resection of the second group of lymph nodes was the standard mode for primary duodenal cancer. Pancreatoduodenectomy was required when the degree of invasion of the stomach was high, and partial duodenal excision was sufficient to radically cure early cancer with invasion of the mucosa but no metastasis to lymph nodes.

Key words
primary carcinoma of the duodenum, prognostic factor, pylorus preserving pancreaticoduodenectomy

Reprint requests
Gen Sugawara Department of Surgery, Ogaki Municipal Hospital 4-86 Minamikawa-cho, Ogaki, 503-0864 JAPAN

Accepted
March 28, 2001

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