Clinicopathologic features and prognosis of duodenal adenocarcinoma and comparison with ampullary and pancreatic ductal adenocarcinoma

• Published in: Human pathology 2013-12, Vol.44 (12), p.2792-2798
• Main Authors: Zenali, Maryam, MD, Overman, Michael J., MD, Rashid, Asif, MD, PhD, Broaddus, Russell B., MD, PhD, Wang, Hua, MD, PhD, Katz, Matthew H., MD, Fleming, Jason B., MD, Abbruzzese, James L., MD, Wang, Huamin, MD, PhD
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Age; Aged; Aged, 80 and over; Ampulla of Vater - pathology; Ampulla of Vater - surgery; Ampullary adenocarcinoma; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Colorectal cancer; Common Bile Duct Neoplasms - mortality; Common Bile Duct Neoplasms - pathology; Common Bile Duct Neoplasms - surgery; Confidence intervals; Duodenal adenocarcinoma; Duodenal Neoplasms - mortality; Duodenal Neoplasms - pathology; Duodenal Neoplasms - surgery; Female; Humans; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - pathology; Male; Medical prognosis; Middle Aged; Pancreatic cancer; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; Pathology; Prognosis; Regression analysis; Surgery; Survival; Treatment Outcome; Tumors
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2013.07.030

Summary Because of the rarity of duodenal adenocarcinoma (DAC), the clinicopathologic features and prognostication data for DAC are limited. There are no published studies directly comparing the prognosis of DAC to that of ampullary adenocarcinoma (AA) and of pancreatic ductal adenocarcinoma (PDA) after resection. In this study, we examined the clinicopathologic features of 68 patients with DAC, 92 patients with AA, and 126 patients with PDA who underwent resection. Patient clinicopathologic and survival information were extracted from medical records. Statistical analysis was performed using Statistical Package for the Social Sciences with 2-sided significance level of .05. Patients with DAC had higher American Joint Committee on Cancer (AJCC) stage than AA patients ( P = .001). Lymph node metastasis ( P = .013) and AJCC stage ( P = .02) correlated with overall survival in DAC patients. Patients with DAC or AA had lower frequencies of lymph node metastasis and positive margin and better survival than those with PDA ( P < .05). However, no differences in nodal metastasis, margin status, or survival were observed between DAC patients and those with AA. Our study showed that lymph node metastasis and AJCC stage are important prognostic factors for overall survival in DAC patients. Patients with DAC had less frequent nodal metastasis and better prognosis than those with PDA. There was no significant difference in prognosis between DAC and AA.