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  1. Incidence and treatment of periampullary duodenal cancer in the U.S. veteran patient population.

    Article - En anglais

    BACKGROUND

    Because fewer than 1000 cases of primary adenocarcinoma of the duodenum have been reported, earlier series are limited by local referral patterns and the long periods of time needed for retrospective reviews.

    METHODS

    This study reports the outcomes of preiampullary duodenal adenocarcinoma treatments in all hospitals of the Department of Veterans Affairs from 1987 through 1991, using computer and tumor registry records.

    Patients were grouped by their most aggressive treatment (resection>operative bypass>percutaneous biliary intubation) and survival calculated from the date of this procedure.

    RESULTS

    Of 2185 patients with periampullary cancers (1753 pancreatic, 432 other periampullary), 85 were duodenal and thus comprised only 4% of periampullary tumors.

    Thirty-four duodenal cancers were resected, 44 bypassed, and 7 had biliary intubation, with 30-day mortality rates of 6%, 18%, and 0%, respectively.

    Mean survival exceeded 1 year in all groups, and resection resulted in a significant increase in mean survival (784 vs. 438 days for nonresection, P=0.01).

    The projected 5-year survival rate after resection was 23%. Mean survival after resection of 9 Stage I-II cancers was 668 days, but was similar after 5 resections with nodal or other metastases.

    Similarly, survival did not correlate with cancer stage in 13 palliated patients.

    CONCLUSIONS

    This large study of patients with duodenal cancer provides a unique perspective of disease prevalence and re...

    Mots-clés Pascal : Adénocarcinome, Duodénum, Homme, Incidence, Epidémiologie, Résection chirurgicale, Traitement, Résultat, Pronostic, Ampoule Vater, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Chirurgie

    Mots-clés Pascal anglais : Adenocarcinoma, Duodenum, Human, Incidence, Epidemiology, Surgical resection, Treatment, Result, Prognosis, Vater ampulla, Malignant tumor, Digestive diseases, Intestinal disease, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0238018

    Code Inist : 002B13B01. Création : 199608.