Outcome after surgical resection for duodenal adenocarcinoma in the UK
Outcome after surgical resection for duodenal adenocarcinoma in the UK
Background
Factors influencing long‐term outcome after surgical resection for duodenal adenocarcinoma are unclear.
Methods
A prospectively created database was reviewed for patients undergoing surgery for duodenal adenocarcinoma in six UK hepatopancreaticobiliary centres from 2000 to 2013. Factors influencing overall survival and disease‐free survival (DFS) were identified by regression analysis.
Results
Resection with curative intent was performed in 150 (84·3 per cent) of 178 patients. The postoperative morbidity rate for these patients was 40·0 per cent and the in‐hospital mortality rate was 3·3 per cent. Patients who underwent resection had a better median survival than those who had a palliative surgical procedure (84 versus 8 months; P < 0·001). The 1‐, 3‐ and 5‐year overall survival rates for patients who underwent resection were 83·9, 66·7 and 51·2 per cent respectively. Median DFS was 53 months, and 1‐ and 3‐year DFS rates were 80·8 and 56·5 per cent respectively. Multivariable analysis revealed that node status (hazard ratio 1·73, 95 per cent c.i. 1·07 to 2·79; P = 0·006) and lymphovascular invasion (hazard ratio 3·49, 1·83 to 6·64; P = 0·003) were associated with overall survival.
Conclusion
Resection of duodenal adenocarcinoma in specialist centres is associated with good long‐term survival. Lymphovascular invasion and nodal metastases are independent prognostic indicators.
676-681
Solaini, L.
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Jamieson, N.B.
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Metcalfe, M.
766b092a-a579-4022-9bdc-8f3ed781089b
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Soonawalla, Z.
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Davidson, B.R.
e17a8932-5f39-462c-9922-c9b609e78f50
McKay, C.
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Kocher, H.M.
cd03697e-acef-4572-9a10-2d0431348618
May 2015
Solaini, L.
e75a6bd8-0d1d-4407-bd38-e79aed2a575d
Jamieson, N.B.
02fdcdd9-3bdd-49e8-9b2d-64c7be7eb0d8
Metcalfe, M.
766b092a-a579-4022-9bdc-8f3ed781089b
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Soonawalla, Z.
c8d278ed-2f08-4cba-849e-a4bb8ac7e8f6
Davidson, B.R.
e17a8932-5f39-462c-9922-c9b609e78f50
McKay, C.
c34ce3ac-e9e2-40ac-a284-e1e1d681082b
Kocher, H.M.
cd03697e-acef-4572-9a10-2d0431348618
Solaini, L., Jamieson, N.B., Metcalfe, M., Abu Hilal, M., Soonawalla, Z., Davidson, B.R., McKay, C. and Kocher, H.M.
(2015)
Outcome after surgical resection for duodenal adenocarcinoma in the UK.
British Journal of Surgery, 102 (6), .
(doi:10.1002/bjs.9791).
(PMID:25776995)
Abstract
Background
Factors influencing long‐term outcome after surgical resection for duodenal adenocarcinoma are unclear.
Methods
A prospectively created database was reviewed for patients undergoing surgery for duodenal adenocarcinoma in six UK hepatopancreaticobiliary centres from 2000 to 2013. Factors influencing overall survival and disease‐free survival (DFS) were identified by regression analysis.
Results
Resection with curative intent was performed in 150 (84·3 per cent) of 178 patients. The postoperative morbidity rate for these patients was 40·0 per cent and the in‐hospital mortality rate was 3·3 per cent. Patients who underwent resection had a better median survival than those who had a palliative surgical procedure (84 versus 8 months; P < 0·001). The 1‐, 3‐ and 5‐year overall survival rates for patients who underwent resection were 83·9, 66·7 and 51·2 per cent respectively. Median DFS was 53 months, and 1‐ and 3‐year DFS rates were 80·8 and 56·5 per cent respectively. Multivariable analysis revealed that node status (hazard ratio 1·73, 95 per cent c.i. 1·07 to 2·79; P = 0·006) and lymphovascular invasion (hazard ratio 3·49, 1·83 to 6·64; P = 0·003) were associated with overall survival.
Conclusion
Resection of duodenal adenocarcinoma in specialist centres is associated with good long‐term survival. Lymphovascular invasion and nodal metastases are independent prognostic indicators.
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More information
Accepted/In Press date: 20 January 2015
e-pub ahead of print date: 16 March 2015
Published date: May 2015
Organisations:
Cancer Sciences
Identifiers
Local EPrints ID: 400318
URI: http://eprints.soton.ac.uk/id/eprint/400318
PURE UUID: 16bd3477-92fa-473b-aa2e-1ad78c1a2a6a
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Date deposited: 14 Sep 2016 12:57
Last modified: 15 Mar 2024 02:14
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Contributors
Author:
L. Solaini
Author:
N.B. Jamieson
Author:
M. Metcalfe
Author:
M. Abu Hilal
Author:
Z. Soonawalla
Author:
B.R. Davidson
Author:
C. McKay
Author:
H.M. Kocher
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