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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1802634
Original Article

Insights into Duodenal Adenocarcinoma: Clinical Presentation, Survival Outcomes, and Treatment Trends—A Long-Term Follow-Up Study

Jason Fernandes Joekim 
1   Department of Pharmacy Practice, Karavali college of Pharmacy, Mangalore, Karnataka, India
,
Subhoth R.C
2   Department of General Medicine, Father Muller Medical College, Mangalore, India
,
Nishitha Shetty
3   Department of Medical Oncology, Father Muller Medical College, Mangalore, India
,
Dinesh Shet 
3   Department of Medical Oncology, Father Muller Medical College, Mangalore, India
› Author Affiliations
Funding None.
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Abstract

Introduction Duodenal adenocarcinoma (DA) is a rare and aggressive malignancy, representing less than 0.5% of all gastrointestinal cancers. It constitutes a significant portion (55.7%) of small bowel adenocarcinomas, most of which arise in the second part of the duodenum, followed by the third and fourth parts. Despite its rarity, DA presents substantial challenges in diagnosis and treatment due to its aggressive nature and often insidious onset.

Objectives The aim of the study is to investigate the clinical presentation, prognostic factors, survival outcomes, and treatment strategies in DA, with a focus on surgical and adjuvant therapeutic interventions. Additionally, the study aims to elucidate patterns of recurrence and identify areas for future research to optimize therapeutic approaches and enhance patient care.

Materials and Methods This retrospective observational study (2015–2023) analyzed patients aged 18 to 90 years with DA. Data from case sheets, laboratory investigations, and medication charts were reviewed. This study aims to explain demographic characteristics, clinical presentations, treatment trends, and survival outcomes to improve therapeutic strategies and patient care in DA patients, excluding other gastrointestinal cancers

Results The study examined 10 cases of DA diagnosed between 2015 and 2023. The patient cohort had an equal gender distribution, with ages ranging from 53 to 83 years. Chief presenting symptoms included abdominal pain (90%) and vomiting (50%). Tumor markers were elevated in 40% of patients. Tumor locations predominantly included the D2 region. Three patients underwent Whipple's surgery and three received chemotherapy with curative intent.

Conclusion The study highlights the challenges associated with DA, including its rare incidence, clinical presentations, and variable treatment outcomes. Surgical interventions such as the Whipple procedure and adjuvant chemotherapy show promise in improving survival rates. Further studies with larger cohorts are essential to better understand the disease, refine therapeutic strategies formulate separate guidelines for DA, and enhance patient outcomes.

Clinical trial registry number: N/A.

Keywords

duodenal adenocarcinoma - gastrointestinal malignancies - small bowel cancer

Consent

A wavier of consent was granted by the Father Muller Institutional Ethics Committee (FMIEC) of Father Muller Research Centre (IRB approval number: FMIEC/CCM/348/2024; date of approval: May 15, 2024).


Authors' Contributions

J.F.J. contributed to concepts, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review. S.R.C. contributed to concepts, design, literature search, clinical studies, data analysis, manuscript preparation, manuscript editing, manuscript review. N.S. contributed to concepts, design, definition of intellectual content, literature search, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review. D.S. contributed to concepts, design, manuscript preparation, manuscript review.




Publication History

Article published online:
12 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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