AUTHOR=Sun Huapeng , Liu Yi , Lv Long , Li Jingwen , Liao Xiaofeng , Gong Wei 

TITLE=Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.795891

DOI=10.3389/fonc.2021.795891

ISSN=2234-943X

ABSTRACT=Backgroup: To evaluate the clinical risk factors influencing overall survival of patients with duodenal adenocarcinoma after tumor resection.
Methods: This study was a retrospective analysis the patients (N = 188) who underwent tumor resection for duodenal adenocarcinoma between January 2005 and June 2020 at xiangyang central hospital. 
Results: Median survival of patients who underwent resectional operation was 54 months longer than that of patients who had palliative surgery was 20.8 months (𝑝 < 0.001; 95%CI 2916.17 916.3-9280.5). Non ampullary duodenal carcinomas survival (50.3months 95%CI 39.7-61.8) was similar to ampullary duodenal carcinomas (59.3months 95%CI 38.6-66.7), but was significantly better than the papilla adenocarcinomas (38.9months 95%CI 29.8-54.8, P=0.386). Those with intestinal type ductal adenocarcinomas had longer median overall survival than those with gastric type (61.8 vs 46.7months, P < 0.01) or pancreatic type (32.2 months, P < 0.001). Clinical DA samples had significantly diverse expression of ATG12, IRS2, and IGF2. Higher expressions of ATG12 and IRS2 proteins were significantly correlated with worse survival. Multivariate Cox regression analysis revealed that lymph node metastasis (HR 6.44, 3.68 to 11.27; 𝑝 <0.0001), Margin status (HR 4.94, 2.85 to 8.54; 𝑝 <0.0001), and high expression of ATG12 (HR 1.89, 1.17 to 3.06 p=0.0099) was independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups with adenocarcinomas of the ampullary, non ampullary, and the papilla by adjuvant chemotherapy treated (p = 0.973).
Conclusion： Gastric/pancreatic type, high expression of ATG12, lymph node metastases, and Margin status were negative prognosticator of survival in patients with duodenal adenocarcinomas than tumor anatomic location. Curative resection is the best treatment for appropriate patients.