Primary carcinoma of the duodenum

Sixty-six patients with primary adenocarcinomas of the duodenum recorded by the Swedish Cancer Register during 1958-1973 are reviewed. The mean age was 66 years, and female:male ratio 1.2:1.0. The predominant symptom was duodenal obstruction. Correct diagnosis was made in 68% by conventional barium meal examination. Hypoton duodenography and duodenoscopy are necessary diagnostic aids. In 25% of the patients the diagnosis was first made at postmortem examination. Thirty-two patients had metastases at first diagnosis. Forty-three per cent were radically operated and 43% palliatively. The operative mortality after curative operations was 25% with no difference correlated to operative methods with the exception of pure polyp extirpation where no patient died. The overall one-year survival was 67% and five-year 18%. There was a tendency for longer survival time for patients with more distally situated carcinomas. Duodenopancreatectomy gave a longer survival time than duodenal resection.