TWELVE CASES OF DUODENAL CANCER

Abstract

Primary adenocarcinoma of the duodenum is rare. It appears in a frequency of 0.8-2.9% of all gastrointestinal cancers. In a period from January 1976 to December 1990, 15 cases were diagnosed as having the carcinoma at the department, and 12 of them were resectable. These 12 resected cases were subjected to a clinicopathological study. The disease was predominant in women. Most patients were in their sixties, with an average age of 64 years old. Common complaints were abdominal pain and nausea/vomiting in 7 cases, which might be caused by stenosis and ulcer. Jaundice was also observed as the chief complaint. The duration of symptoms was mostly within 3 months, ranging from zero to 12 months. Eleven patients had a tubular adenocarcinoma and one had an anaplatic carcinoma. It would appear that fiberscopic endoscopy of the upper gastrointestinal tract should become the major diagnostic tool for this disease. The majority of tumors were located in the suprapapillary and gross appearance was almost ulcerative type. The resectability rate was 80%; pancreatoduodenectomy was performed in 8 cases segmental resection in 2 cases and distal gastrectomy in 2 cases. The prognosis of duodenal carcinoma is poor, and the patients often die of liver metastasis or peritonitis. Multidisciplinary therapy including radiotherapy and chemotherapy would be the only way to attain a higher percentage of cures.