The Clinical Features, Surgical Treatment And Prognosis Of Primary Duodenal Carcinoma

Objective: According to the description of the clinical features(such as start ofsymptoms, tumor location, size, histological type, etc), diagnosis, treatment andprognostic factors and other indicators of primary malignant duodenal, it expect toimprove disease diagnosis inspection efficiency and control postoperative complications,and to clarify its prognostic factors.Methods: Collecting the patients with diagnosed by pathological examination inprimary duodenal cancer in our hospital January2004-January2014period. All thepatients’ clinical data were complete and clear staging uncontroversial. Included100patients of PDC,41cases were male, aged39-89years, mean age was (67.75±4.51)years, mean duration was90days. The clinical data and telephone follow-up results ofall patients were retrospectively studied, including gender, age, tumor size and location,symptoms, pathological type, surgical methods. Application of SPSS18.0software forstatistical analysis, using an independent t test, χ2test, fisher test, survival analysisusing Kaplan-Meier method, compare survival using log-rank test, multivariateanalysis using Cox regression analysis, P <0.05was considered statistically significant.Results: Mortality of100cases patients of primary duodenal cancer was50.0%for6month,61.0%for1-year,81.0%for2-year,90.0%for5-year; clinicalmanifestations include upper abdominal pain and discomfort, jaundice, vomiting,black stools, poor appetite, weight loss, anemia and abdominal mass,and upperabdominal pain was the highest incidence, jaundice Secondly, anemia, abdominaldistension, followed;80cases of patients occurred within the first symptom in4h, andthe remaining20cases was outside4h, and the most common symptom is abdominalpain; common tumor location was nipple and descending portion, the most commonpathological type was adenocarcinoma, followed by malignant stromal tumors, morepatients has exceeded even reach the whole layer of intestinal serosa. CT scan, MRTscan, Ultrasound, and MRCP prompt rate were more than60%, four way diagnosisrate was60.0%(12/20),75.0%(6/8),70.0%(14/20),77.8%(7/9); surgery can significantly improve survival, and pancreaticoduodenectomy most commonly used,the most common complications was pancreatic fistula, followed by wound infection.Univariate analysis showed that the initial symptom duration less than4months, thedegree of tumor differentiation, tumor size, whether the surgery and surgery can affect5-year survival rate of primary duodenal cancer, further multivariate Cox regressionline of research, the conclusion is that the degree of tumor differentiation and underwentsurgery is the prognosis independent factors of primary malignant duodenal.Conclusion: The clinical manifestations of primary malignant duodenal was lackof specificity, early diagnosis was difficult, clinical manifestations and various auxiliarydiagnostic programs were the primary means of early diagnosis of duodenal cancer. Theinitial symptom duration less than4months, degree of tumor differentiation, tumordiameter, surgical and surgical approach is prognosis factors of primary duodenalcarcinoma. Multivariate analysis determined that the degree of tumor differentiation andunderwent surgery were independent factors of the primary duodenal carcinoma.