Gastric gastrointestinal stromal tumors: therapeutic strategies and long-term prognosis

被引:1
作者
Shou, Chunhui [1 ]
Chen, Zhou [1 ]
Li, Zhijian [2 ,3 ]
Yang, Weili [1 ]
Zhang, Qing [1 ]
Bai, Hao [4 ]
Yu, Jiren [1 ,5 ]
机构
[1] Zhejiang Univ, Sch Med, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hangzhou, Peoples R China
[2] Zhejiang Univ, Canc Inst, Sch Med, Hangzhou, Peoples R China
[3] Zhejiang Univ, Inst Translat Med, Sch Med, Hangzhou, Peoples R China
[4] Zhejiang Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Hangzhou, Zhejiang, Peoples R China
[5] Zhejiang Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Sch Med, 79,Qingchun Rd, Hangzhou 310003, Zhejiang, Peoples R China
关键词
Gastric GIST; endoscopic resection; recurrence-free survival; imatinib; prognosis; MINIMALLY INVASIVE RESECTION; LAPAROSCOPIC RESECTION; ENDOSCOPIC RESECTION; RECURRENCE; GIST; GUIDELINES; DIAGNOSIS; IMATINIB; OUTCOMES; SURGERY;
D O I
10.1080/00365521.2023.2270758
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives This study aimed to evaluate the clinical and prognostic characteristics of primary gastric gastrointestinal stromal tumors (GIST).Methods Patients who underwent resection for primary gastric GIST between January 2002 and December 2017 were included. Recurrence-free survival (RFS) was calculated by Kaplan-Meier analysis, and Cox proportional hazards model was used to identify independent prognostic factors.Results Altogether, 653 patients were enrolled. The median patient age was 59 years (range 15-86 years). Open, laparoscopic, and endoscopic resections were performed in 394 (60.3%), 105 (16.1%), and 154 (23.6%) patients, respectively. According to the modified NIH consensus classification, 132 (20.2%), 245 (37.5%), 166 (25.4%), and 88 (13.5%) patients were categorized into very low-, low-, intermediate-, and high-risk, respectively. A total of 136 (20.8%) patients received adjuvant imatinib treatment. The median follow-up time was 78 months (range 4-219 months), and the estimated 5-year RFS rate was 93.0%. In all patients, tumor size and rupture, mitotic counts, and adjuvant imatinib treatment were independent prognostic factors. The prognosis of gastric GIST treated with endoscopic resection was not significantly different from that of laparoscopic or open resection after adjusting for covariates using propensity score matching (log-rank p = .558). Adjuvant imatinib treatment (HR = 0.151, 95%CI 0.055-0.417, p < .001) was a favorable prognostic factor for high-risk patients, but was not associated with prognosis in intermediate-risk patients.Conclusion Patients with small gastric GISTs who successfully underwent endoscopic resection may have a favorable prognosis. Adjuvant imatinib treatment improve the prognosis of high-risk gastric GISTs, however, its use in intermediate-risk patients remains controversial.
引用
收藏
页码:239 / 245
页数:7
相关论文
共 26 条
[1]   Endoscopic submucosal dissection for gastric gastrointestinal stromal tumors: a retrospective cohort study [J].
An, Wei ;
Sun, Ping-Bo ;
Gao, Jie ;
Jiang, Fei ;
Liu, Feng ;
Chen, Jie ;
Wang, Dong ;
Li, Zhao-Shen ;
Shi, Xin-Gang .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2017, 31 (11) :4522-4531
[2]   Endoscopic resection of gastric gastrointestinal stromal tumors originating from the muscularis propria layer in North America: methods and feasibility data [J].
Andalib, Iman ;
Yeoun, Daniel ;
Reddy, Ramesh ;
Xie, Steve ;
Iqbal, Shahzad .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2018, 32 (04) :1787-1792
[3]   Open Versus Minimally Invasive Resection of Gastric GIST: A Multi-Institutional Analysis of Short- and Long-Term Outcomes [J].
Bischof, Danielle A. ;
Kim, Yuhree ;
Dodson, Rebecca ;
Jimenez, M. Carolina ;
Behman, Ramy ;
Cocieru, Andrei ;
Blazer, Dan G., III ;
Fisher, Sarah B. ;
Squires, Malcolm H., III ;
Kooby, David A. ;
Maithel, Shishir K. ;
Groeschl, Ryan T. ;
Gamblin, T. Clark ;
Bauer, Todd W. ;
Karanicolas, Paul J. ;
Law, Calvin ;
Quereshy, Fayez A. ;
Pawlik, Timothy M. .
ANNALS OF SURGICAL ONCOLOGY, 2014, 21 (09) :2941-2948
[4]   Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up [J].
Casali, P. G. ;
Blay, J. Y. ;
Abecassis, N. ;
Bajpai, J. ;
Bauer, S. ;
Biagini, R. ;
Bielack, S. ;
Bonvalot, S. ;
Boukovinas, I ;
Bovee, J. V. M. G. ;
Boye, K. ;
Brodowicz, T. ;
Buonadonna, A. ;
De Alava, E. ;
Dei Tos, A. P. ;
Del Muro, X. G. ;
Dufresne, A. ;
Eriksson, M. ;
Fedenko, A. ;
Ferraresi, V ;
Ferrari, A. ;
Frezza, A. M. ;
Gasperoni, S. ;
Gelderblom, H. ;
Gouin, F. ;
Grignani, G. ;
Haas, R. ;
Hassan, A. B. ;
Hindi, N. ;
Hohenberger, P. ;
Joensuu, H. ;
Jones, R. L. ;
Jungels, C. ;
Jutte, P. ;
Kasper, B. ;
Kawai, A. ;
Kopeckova, K. ;
Krakorova, D. A. ;
Le Cesne, A. ;
Le Grange, F. ;
Legius, E. ;
Leithner, A. ;
Lopez-Pousa, A. ;
Martin-Broto, J. ;
Merimsky, O. ;
Messiou, C. ;
Miah, A. B. ;
Mir, O. ;
Montemurro, M. ;
Morosi, C. .
ANNALS OF ONCOLOGY, 2022, 33 (01) :20-33
[5]   Final analysis of the randomized trial on imatinib as an adjuvant in localized gastrointestinal stromal tumors (GIST) from the EORTC Soft Tissue and Bone Sarcoma Group (STBSG), the Australasian Gastro-Intestinal Trials Group (AGITG), UNICANCER, French Sarcoma Group (FSG), Italian Sarcoma Group (AGITG), UNICANCER, French Sarcoma Group (FSG), Italian Sarcoma Group (ISG), and Spanish Group for Research on Sarcomas (GEIS) [J].
Casali, P. G. ;
Le Cesne, A. ;
Velasco, A. P. ;
Kotasek, D. ;
Rutkowski, P. ;
Hohenberger, P. ;
Fumagalli, E. ;
Judson, I. R. ;
Italiano, A. ;
Gelderblom, H. ;
Penel, N. ;
Hartmann, J. T. ;
Duffaud, F. ;
Goldstein, D. ;
Martin-Broto, J. ;
Gronchi, A. ;
Wardelmann, E. ;
Marreaud, S. ;
Zalcberg, J. R. ;
Litiere, S. ;
Blay, J-Y .
ANNALS OF ONCOLOGY, 2021, 32 (04) :533-541
[6]   Endoscopic versus laparoscopic resection of gastric gastrointestinal stromal tumors: a multicenter study [J].
Dai, Wei-Jie ;
Liu, Gao ;
Wang, Min ;
Liu, Wen-Jie ;
Song, Wei ;
Yang, Xiao-Zhong ;
Wang, Qi-Long ;
Zhang, Xiao-Yu ;
Fan, Zhi-Ning .
ONCOTARGET, 2017, 8 (07) :11259-11267
[7]   Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST) [J].
DeMatteo, Ronald P. ;
Gold, Jason S. ;
Saran, Lisa ;
Goenen, Mithat ;
Liau, Kui Hin ;
Maki, Robert G. ;
Singer, Samuel ;
Besmer, Peter ;
Brennan, Murray F. ;
Antonescu, Cristina R. .
CANCER, 2008, 112 (03) :608-615
[8]   Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline [J].
Deprez, Pierre H. ;
Moons, Leon M. G. ;
O'Toole, Dermot ;
Gincul, Rodica ;
Seicean, Andrada ;
Pimentel-Nunes, Pedro ;
Fernandez-Esparrach, Gloria ;
Polkowski, Marcin ;
Vieth, Michael ;
Borbath, Ivan ;
Moreels, Tom G. ;
van Dijkum, Els Nieveen ;
Blay, Jean-Yves ;
van Hooft, Jeanin E. .
ENDOSCOPY, 2022, 54 (04) :412-429
[9]   Incidence of Sarcoma Histotypes and Molecular Subtypes in a Prospective Epidemiological Study with Central Pathology Review and Molecular Testing [J].
Ducimetiere, Francoise ;
Lurkin, Antoine ;
Ranchere-Vince, Dominique ;
Decouvelaere, Anne-Valerie ;
Peoc'h, Michel ;
Istier, Luc ;
Chalabreysse, Philippe ;
Muller, Christine ;
Alberti, Laurent ;
Bringuier, Pierre-Paul ;
Scoazec, Jean-Yves ;
Schott, Anne-Marie ;
Bergeron, Christophe ;
Cellier, Dominic ;
Blay, Jean-Yves ;
Ray-Coquard, Isabelle .
PLOS ONE, 2011, 6 (08)
[10]   Gastric and Small Intestine Gastrointestinal Stromal Tumors: Do Outcomes Differ? [J].
Giuliano, Katherine ;
Nagarajan, Neeraja ;
Canner, Joseph ;
Najafian, Alireza ;
Wolfgang, Christopher ;
Schneider, Eric ;
Meyer, Christian ;
Lennon, Anne Marie ;
Johnston, Fabian M. ;
Ahuja, Nita .
JOURNAL OF SURGICAL ONCOLOGY, 2017, 115 (03) :351-357