Liao LG, Xiong ZG, Hu JJ. Progress in the treatment of duodenal cancer: A comprehensive review. World J Gastrointest Oncol 2025; 17(7): 105712 [DOI: 10.4251/wjgo.v17.i7.105712]
Corresponding Author of This Article
Jun-Jie Hu, MD, Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 116 Zuodaoquan South Road, Wuhan 430079, Hubei Province, China. 791462122@qq.com
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jul 15, 2025; 17(7): 105712 Published online Jul 15, 2025. doi: 10.4251/wjgo.v17.i7.105712
Progress in the treatment of duodenal cancer: A comprehensive review
Liang-Gong Liao, Zhi-Guo Xiong, Jun-Jie Hu
Liang-Gong Liao, Zhi-Guo Xiong, Jun-Jie Hu, Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Liang-Gong Liao, Zhi-Guo Xiong, Jun-Jie Hu, Hubei Provincial Clinical Research Center for Colorectal Cancer, Wuhan 430079, Hubei Province, China
Liang-Gong Liao, Zhi-Guo Xiong, Jun-Jie Hu, Wuhan Clinical Research Center for Colorectal Cancer, Wuhan 430079, Hubei Province, China
Author contributions: Hu JJ conceived the study; Liao LG and Xiong ZG wrote the manuscript; All authors read and approved the final manuscript.
Supported by Research Projects of Biomedical Center of Hubei Cancer Hospital, No. 2022SWZX07; 2023-2024 Annual Scientific Research Project of Traditional Chinese Medicine from Hubei Provincial Administration of Traditional Chinese Medicine, No. ZY2023Z005; and Health Commission of Hubei Province Scientific Research Project, No. WJ2023Z011.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Jie Hu, MD, Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 116 Zuodaoquan South Road, Wuhan 430079, Hubei Province, China. 791462122@qq.com
Received: February 5, 2025 Revised: April 4, 2025 Accepted: May 30, 2025 Published online: July 15, 2025 Processing time: 159 Days and 23 Hours
Abstract
Duodenal cancer, a rare gastrointestinal malignancy (30%-45% of small bowel cancers), shows improved outcomes with multidisciplinary advances. Endoscopic resection is preferred for early-stage (Tis/T1) tumors (66% usage), enhancing survival (hazard ratio [HR]: 0.70) and reducing infection-related mortality vs surgery (P = 0.03). Advanced cases rely on surgical resection (segmental/Whipple, 46.4% 5-year survival) with minimally invasive techniques reducing blood loss. Poor prognosis links to nodal metastasis (HR: 2.58) and vascular invasion (HR: 2.18). Patients with stage III disease benefit from FOLFOX chemotherapy (HR: 0.55), while neoadjuvant chemoradiotherapy improves resectability. Targeted therapies (erb-b2 receptor tyrosine kinase 2/epidermal growth factor receptor/phosphatidylinositol-3-kinase-protein kinase B-mechanistic target of rapamycin kinase) yield complete responses with trastuzumab-chemotherapy combinations. Immunotherapy (pembrolizumab) achieves organ preservation in microsatellite instability-high/mismatch repair-deficient locally advanced tumors. Molecular profiling (caudal type homeobox 2, cell-free DNA, microsatellite instability) guides personalized therapy. Future priorities include global collaborations for precision strategies and novel biomarkers, integrating surgical, targeted, and immunotherapeutic advances to optimize survival and quality of life.
Core Tip: Duodenal cancer, a rare gastrointestinal malignancy, requires multidisciplinary strategies. Endoscopic resection for early-stage tumors improves survival and reduces infection mortality. Advanced cases benefit from surgery and minimally invasive techniques. Chemotherapy and neoadjuvant chemoradiotherapy enhance outcomes. Targeted therapies such as erb-b2 receptor tyrosine kinase 2 (human epidermal growth factor receptor 2)/phosphatidylinositol-3-kinase inhibitors and immunotherapy show transformative potential. Molecular profiling guides precision medicine. International collaboration is critical to optimize biomarker-driven strategies and improve survival. This review integrates innovations in surgery, systemic therapy, and immunotherapy, offering a roadmap for personalized management.
