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Duodenal villous tumors.
K J Bjork1, C J Davis, D M Nagorney
1Department of Surgery, Mayo Clinic, Rochester, Minn. 55905.
Archives of Surgery (Chicago, Ill. : 1960)
|August 1, 1990
Summary
Local excision is effective for duodenal villous tumors without invasive cancer. However, invasive carcinoma necessitates radical resection, offering a 45% five-year survival rate.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Duodenal villous tumors are rare neoplasms.
- These tumors can range from benign adenomas to invasive carcinomas.
- Periampullary location is common for duodenal villous tumors.
Purpose of the Study:
- To review the long-term outcomes of surgical treatments for duodenal villous tumors.
- To correlate treatment strategies with adenoma histopathology.
- To evaluate the efficacy of different surgical approaches.
Main Methods:
- Retrospective review of 36 patients with duodenal villous tumors.
- Surgical treatments included transduodenal submucosal excision and radical pancreaticoduodenectomy.
- Analysis of histopathology, perioperative outcomes, recurrence rates, and survival.
Main Results:
- Epithelial atypia, in situ carcinoma, and invasive carcinoma were present in 30%, 14%, and 33% of patients, respectively.
- Transduodenal submucosal excision had lower perioperative morbidity (16%) compared to pancreaticoduodenectomy (47%).
- Recurrence of benign adenomas occurred in 17% after 5 years with local excision; 5-year survival for invasive cancer was 45% with radical resection.
Conclusions:
- Duodenal villous tumors without invasive cancer are successfully managed with local submucosal excision.
- Radical resection is required for invasive duodenal villous carcinoma.
- Treatment choice should be guided by histopathological findings to optimize patient outcomes.