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Background: This study examined prognostic discrimination by lymph node staging for duodenal adenocarcinoma and compared the nodal stage–specific survival with that associated with gastric antral adenocarcinoma.

Method: Prospectively maintained databases from 1983 to 2000 were reviewed to identify 137 patients with duodenal adenocarcinoma and 545 patients with gastric antral adenocarcinoma at a single institution.

Results: R0 resection was performed for 72 patients with duodenal cancer. At least 15 lymph nodes were retrieved in 34 cases (47%). Lymph node metastasis (pN⁺) was detected in 31 patients (43%). With median follow-up of 36 months, the pN category was an independently significant prognostic factor (pN0, 5-year disease-specific survival of 83%, vs. pN⁺, 56%; P = .03). The survival difference between pN0 and pN⁺ was pronounced in patients with ≥15 nodes (100% vs. 47 …