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- Title
Cytoreductive surgery offers prognostic benefits in metastatic gastrointestinal stromal tumors with generalized progression following imatinib therapy: a single institute retrospective study.
- Authors
Liu, Dao-Ning; Jia, Wei-Wei; Wang, Hai-Yue; Wu, Jian-Hui; Li, Cheng-Peng; Hao, Chun-Yi
- Abstract
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Distant metastasis has been detected in approximately 50% of GIST patients at the first diagnosis. The surgical strategy for metastatic GIST with generalized progression (GP) after imatinib therapy remains unclear. Methods: We recruited 15 patients with imatinib-resistant metastatic GIST. They received cytoreductive surgery (CRS) for tumor rupture, intestinal obstruction and gastrointestinal bleeding. We collected clinical, pathological and prognostic data for analyses. Results: OS and PFS after R0/1 CRS were 56.88 ± 3.47 and 26.7 ± 4.12 months, respectively, when compared with 26 ± 5.35 and 5 ± 2.78 months after R2 CRS (P = 0.002 and P < 0.001, respectively). The OS of patients from the initiation of imatinib in the R0/1 group was 133.90 ± 15.40 months when compared with 59.80 ± 10.98 months in the R2 CRS group. There were two significant grade III complications after 15 operations (13.3%). No patient underwent reoperation. In addition, no perioperative death occurred. Conclusions: R0/1 CRS is highly probable to provide prognostic benefits for patients with metastatic GIST who experience GP following imatinib treatment. An aggressive surgical strategy for achieving R0/1 CRS can be deemed safe. If applicable, R0/1 CRS should be carefully considered in imatinib-treated patients with GP metastatic GIST.
- Subjects
CYTOREDUCTIVE surgery; CANCER invasiveness; GASTROINTESTINAL stromal tumors; IMATINIB; METASTASIS; BOWEL obstructions; GASTROINTESTINAL surgery
- Publication
BMC Surgery, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2482
- Publication type
Article
- DOI
10.1186/s12893-023-02087-3