Management and Outcome of Patients with Sporadic Gastrinoma Arising in the Duodenum

Theresa G. Zogakis, Fathia Gibril, Steven K. Libutti, Jeffrey A. Norton, Donald E. White, Robert T. Jensen, H. Richard Alexander

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68 Scopus citations

Abstract

Background: Primary duodenal gastrinomas are now recognized as a common etiology for patients with sporadic Zollinger Ellison Syndrome (ZES); however, the clinical and pathologic features of this condition and long-term outcome after operation are not well characterized. Methods: Between November 1982 and September 2000, 63 patients diagnosed with sporadic ZES underwent resection of a primary duodenal gastrinoma and regional nodal metastases with curative intent. Data from a prospectively maintained database were reviewed for clinical and pathologic parameters relating to primary tumor size, location, frequency of lymph node metastases, and disease-specific and disease-free survival. Results: There were 41 males and 22 females (mean age, 48.6 years). The majority of duodenal gastrinomas were in the first or second portions of the duodenum (83%). Tumor size ranged from 0.2 to 2.0 cm with 62% measuring less than 1.0 cm. Sixty percent of individuals had regional lymph node metastases identified primarily in proximity to the primary tumor. At a median 10-year follow-up, the overall disease-specific and disease-free survivals were 100% and 60%, respectively. Actuarial 10-year disease-free survival was significantly higher for patients without lymph node metastases versus those with lymph node metastases (78% versus 48%, P = 0.0137). Conclusions: Duodenal gastrinomas in patients with sporadic ZES are frequently small, most commonly located in the proximal duodenum, and associated with regional lymph node metastases in 60%. Disease-free survival is lower for patients with regional lymph node metastases suggesting that a more systematic lymphadenectomy to extirpate occult disease may be indicated in this group.

Original languageEnglish (US)
Pages (from-to)42-48
Number of pages7
JournalAnnals of Surgery
Volume238
Issue number1
DOIs
StatePublished - Jul 2003
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Zogakis, T. G., Gibril, F., Libutti, S. K., Norton, J. A., White, D. E., Jensen, R. T., & Alexander, H. R. (2003). Management and Outcome of Patients with Sporadic Gastrinoma Arising in the Duodenum. Annals of Surgery, 238(1), 42-48. https://doi.org/10.1097/00000658-200307000-00006