Buddhika Thilakarathna, M.H. Renos, Kavishangari Jeyalogaindran and Pavani Jinadasa
Lymph node positivity is one of the most important prognostic indicators and a wide lymphadenectomy should be routinely performed. In one study done in 101 patients with duodenal adenocarcinoma, the three and five years survival rates of patients with negative nodes were 73% and 68%, respectively, compared with 35% and 22% in patients with nodal metastases.
Although data are limited guiding adjuvant therapy options, oxaliplatin based chemotherapy is typically offered to high risk patients, such as those with positive lymph nodes. In some series, adjuvant radiation is associated with improved local control but no difference in overall survival.
The rarity of the incidence of duodenal carcinomas make it is a challenging entity to manage. Extreme rarity of the adenocarcinoma at ligament of trietz also made the true incidence of adenocarcinoma is unknown. Nevertheless, duodenal adenocarcinomas constitute about 0.3% to 0.4% of all GIT cancers.