TY - JOUR
T1 - Clinical outcomes of patients with duodenal adenocarcinoma and intestinal-type papilla of Vater adenocarcinoma
AU - Meijer, Laura L.
AU - Strijker, Marin
AU - de Bakker, Jacob K.
AU - Toennaer, Jurgen G. J.
AU - Zonderhuis, Barbara M.
AU - van der Vliet, Hans J.
AU - Wilmink, Hanneke
AU - Verheij, Joanne
AU - Daams, Freek
AU - Busch, Olivier R.
AU - van Grieken, Nicole C. T.
AU - Besselink, Marc G.
AU - Kazemier, Geert
N1 - Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Clinical outcomes
KW - Duodenal adenocarcinoma
KW - Local treatment
KW - Metastases
KW - Papilla of vater adenocarcinoma
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85084377831&partnerID=8YFLogxK
U2 - https://doi.org/10.4251/WJGO.V12.I3.347
DO - https://doi.org/10.4251/WJGO.V12.I3.347
M3 - Article
C2 - 32206184
SN - 1948-5204
VL - 12
SP - 347
EP - 357
JO - World journal of gastrointestinal oncology
JF - World journal of gastrointestinal oncology
IS - 3
ER -