Primary duodenal gastrinomas are a common etiology for patients with sporadic Zollinger Ellison Syndrome (ZES).
However, the clinical and pathologic features of this condition, and the long-term outcome after operation are not defined.
In this study, researchers from the United States evaluated 63 (41 male, mean age 48.6 years) patients diagnosed with sporadic ZES. Patients underwent curative resection of primary duodenal gastrinoma and regional nodal metastases, between 1982 and 2000.
|60% of patients had regional lymph node metastases.|
|Annals of Surgery|
The team reviewed data relating to primary tumor size, location, frequency of lymph node metastases, and disease-specific and disease-free survival.
The researchers found that 83% of the gastrinomas were in the first or second portions of the duodenum.
Tumor size ranged between 0.2 and 2 cm. Overall, 62% measured less than 1 cm.
The team also found that 60% of patients had regional lymph node metastases, in proximity to the primary tumor.
They determined that, after a median 10-year follow-up, the overall disease-specific survival was 100%, and disease-free survival was 60%.
The team found that actuarial 10-year disease-free survival was higher in patients without lymph node metastases (78%), compared with patients with lymph node metastases (48%).
Dr Theresa Zogakis's team concluded, "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".