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Background: Duodenal adenocarcinoma (DA) is a rare malignancy, and the effectiveness of adjuvant chemotherapy on survival after surgical intervention remains ambiguous. This study investigates the impact of adjuvant chemotherapy on overall survival (OS) and recurrence-free survival (RFS) in patients with resectable DA. Materials and methods: Data from ninety-eight stage I-III DA patients who underwent surgical resection between January 1998 and December 2021 at two Chinese institutions were analyzed retrospectively. Survival outcomes were assessed using the Kaplan-Meier method, and multivariable Cox proportional hazards models identified significant prognostic factors. Results: Of the 98 patients, 45 received adjuvant chemotherapy and 53 did not. The median follow-up was 49 months. Patients who had adjuvant chemotherapy showed a longer median OS (52.9 vs. 25.1 months, p=0.003) and RFS (38.2 vs. 9.9 months, p<0.001) than those without. N stage was associated with reduced OS and RFS. Multivariate analysis identified adjuvant chemotherapy, N stage, and CA199 as independent predictors for RFS and OS. For patients with initial CA199 ≥ 27U/mL, adjuvant chemotherapy appeared to be associated with improvements in RFS and OS, alongside suggestive reductions in recurrence and mortality risks. Conclusion: Adjuvant chemotherapy correlates with an extended median OS and RFS, as well as a reduced risk of recurrence and mortality in patients who have undergone surgical resection for DA. Specifically, patients with DA who are in the N1 or N2 stage, or those with a CA199≥27U/mL at their initial diagnosis, may show potential clinical benefits from adjuvant chemotherapy as a preliminary exploratory finding.
Liu et al. (Tue,) studied this question.