Villous tumors of the duodenum: a retrospective study of 47 cases by the French Associations for Surgical Research.

Abstract

BACKGROUND:

We evaluated villous tumors of the duodenum in regard to preoperative diagnosis of malignancy and the choice of treatment.

STUDY DESIGN:

From January 1974 to October 1992, forty-seven patients with a benign or malignant tumor arising from the duodenal mucosa were studied. Forty-two patients underwent a macroscopically complete resection of the tumor. Nineteen tumors were malignant.

RESULTS:

Preoperative endoscopic biopsy results had a 52 percent sensitivity and 100 percent specificity for the diagnosis of malignancy. For the 42 patients who underwent complete resection, jaundice was predictive of malignancy (p < 0.01), whereas tumor size was not (p < 0.2). The five-year survival rate of this group was 69.5 percent (confidence interval: 50 to 84). The recurrence rate was higher (p < 0.01) and the survival rate shorter (p < 0.001) for patients who underwent ampullectomy (n = 8) compared with patients treated by limited resection (n = 20) or pancreatoduodenectomy (n = 14).

CONCLUSIONS:

Preoperative diagnosis of malignancy is difficult for villous tumors of the duodenum. For tumors located near the papilla, it seems that pancreatoduodenectomy is the best treatment.

• Authors: D Pezet, N Rotman, K Slim, M J Boudet, J Chipponi, P L Fagniez
• Journal: Journal of the American College of Surgeons (J Am Coll Surg) Vol. 180 Issue 5 Pg. 541-4 (May 1995) ISSN: 1072-7515 [Print] United States
• PMID: 7749529 (Publication Type: Journal Article)

Topics

• Actuarial Analysis
• Adenoma, Villous (diagnosis, mortality, secondary, surgery)
• Aged
• Biopsy
• Confidence Intervals
• Duodenal Neoplasms (diagnosis, mortality, surgery)
• Duodenoscopy
• Female
• Follow-Up Studies
• France
• Humans
• Liver Neoplasms (diagnosis, secondary)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, surgery)
• Pancreaticoduodenectomy
• Preoperative Care
• Reproducibility of Results
• Retrospective Studies
• Societies, Medical
• Survival Rate
• Tomography, X-Ray Computed