Clinical outcomes of patients with duodenal adenocarcinoma and intestinal-type papilla of Vater adenocarcinoma

• 作者: Barbara M Zonderhuis Freek Daams Geert Kazemier Hanneke Wilmink Hans J van der Vliet Jacob K de Bakker Joanne Verheij Jurgen GJ Toennaer Laura L Meijer Marc G Besselink Marin Strijker Nicole CT van Grieken Olivier R Busch
• 来源期刊: 世界胃肠肿瘤学杂志:英文版(电子版)
• 学科: 医学
• 关键词: DUODENAL ADENOCARCINOMA PAPILLA of VATER ADENOCARCINOMA Clinical outcomes Local treatment METASTASES Survival
• 年，卷（期）: 2020,（3）
• 页码范围: 347-357
• 页数: 11页
• 分类号: R73

摘要

BACKGROUND Duodenal adenocarcinoma(DA)and intestinal-type papilla of Vater adenocarcinoma(it-PVA)are rare malignancies of the gastrointestinal tract.Current therapeutic options are translated nowadays from treatment strategies for patients with colorectal cancer due to histopathological similarities.AIM To retrospectively investigate the clinical outcome of patients with DA and it-PVA.METHODS All patients with DA and it-PVA diagnosed between 2000 and 2017 were included at two academic centers in the Netherlands.All patients with histopathologically-confirmed DA or it-PVA were eligible for inclusion.Clinical outcome was compared between DA and it-PVA per disease stage.In the subgroup of stage IV disease,survival after local treatment of oligometastases was compared with systemic therapy or supportive care.RESULTS In total,155 patients with DA and it-PVA were included.Patients with it-PVA more often presented with stage I disease,while DA was more often diagnosed at stage IV(P<0.001).Of all patients,79%were treated with curative intent.The median survival was 39 mo,and no difference in survival was found for patients with DA and it-PVA after stratification for disease stage.Seven(23%)of 31 patients with synchronous stage IV disease underwent resection of the primary tumor,combined with local treatment of oligometastases.Local treatment of metastases was associated with an overall survival of 37 mo,compared to 14 and 6 mo for systemic therapy and supportive care,respectively.CONCLUSION Survival of patients with DA and it-PVA is comparable per disease stage.These results suggest a potential benefit for local treatment strategies in selected patients with oligometastases,although additional prospective studies are needed.