['The aims of this paper were to evaluate the clinical features of patients with primary duodenal adenocarcinoma and to address the prognostic relevance of different surgical and pathological variables after potentially curative pancreaticoduodenectomy.', 'Patients with primary duodenal adenocarcinoma observed from 2000 through 2009 were identified from a single-institution electronic database. Univariate and multivariate analyses were performed to identify factors associated with survival.', 'The study population consisted of 37 patients. Of these, 25 underwent pancreaticoduodenectomy, while the remaining 12 were not amenable to resection and underwent bypass operations or were given best supportive care. Overall survival after radical resection (R0) was significantly longer than after palliative surgery (180 versus 35\xa0months, p\u2009=\u20090.013). On multivariate analysis, tumor grade (hazard ratio (HR)\u2009=\u20091.345, 95% CI\u2009=\u20091.28-1.91, p\u2009=\u20090.03) and the occurrence of postoperative or abdominal complications (HR\u2009=\u20091.781, 95% CI\u2009=\u20091.10-2.89, p\u2009=\u20090.037; HR\u2009=\u20091.878, 95% CI\u2009=\u20091.21-3.08, p\u2009=\u20090.029) were found to be significant prognostic factors for survival in patients undergoing potentially curative resection. In particular, median survival was 180\xa0months in patients with an uneventful postoperative course and 52\xa0months in those with abdominal complications. The 5-year overall survival rates were 100 and 60\xa0%, respectively.'] Is postoperative morbidity an additional prognostic factor after potentially curative pancreaticoduodenectomy for primary duodenal adenocarcinoma?