Endoscopic Resection Versus Surgical Resection for T1/T2 Duodenal Adenocarcinoma: Considerations of Nodal Upstaging

Among clinically node-negative T1/T2 duodenal adenocarcinomas, 40% of patients who underwent major resections had lymph node upstaging, which was associated with worse survival; lymphovascular invasion, poor differentiation, and older age were significant predictors of nodal upstaging. The importance of these findings underscores the need for duodenal adenocarcinoma-specific guidelines to guide endoscopic resection in early T-stage disease.