Radical resection versus local excision for low rectal gastrointestinal stromal tumor: A multicenter propensity score-matched analysis

被引：9

作者：

Wang, Tao ^{[1
]}

Zhao, Yan ^{[2
]}

Wang, Ming ^{[3
]}

Zhang, Peng ^{[1
]}

Lin, Guole ^{[4
]}

Liu, Qian ^{[5
]}

Feng, Fan ^{[6
]}

Xiong, Zhiguo ^{[7
]}

Hu, Junbo ^{[8
]}

Zhang, Bo ^{[9
]}

Ye, Yingjiang ^{[10
]}

Xia, Lijian ^{[11
]}

Tao, Kaixiong ^{[1
]}

机构：

[1] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Gastrointestinal Surg, Wuhan 430022, Peoples R China

[2] China Med Univ, Dept Gastr Surg, Liaoning Canc Hosp & Inst, Canc Hosp, Shenyang, Peoples R China

[3] Shanghai Jiao Tong Univ, Renji Hosp, Dept Gastrointestinal Surg, Sch Med, Shanghai, Peoples R China

[4] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Gen Surg, Beijing, Peoples R China

[5] Chinese Acad Med Sci & Peking Union Coll, Dept Colorectal Surg, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China

[6] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Dept Digest Surg, Xian, Peoples R China

[7] Huazhong Univ Sci & Technol, Hubei Canc Hosp, Tongji Med Coll, Dept Gastrointestinal Surg, Wuhan, Peoples R China

[8] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Gastrointestinal Surg, Wuhan, Peoples R China

[9] Sichuan Univ, West China Hosp, Dept Gastrointestinal Surg, Chengdu, Peoples R China

[10] Peking Univ Peoples Hosp, Dept Gastrointestinal Surg, Beijing 100044, Peoples R China

[11] Shandong First Med Univ, Affiliated Hosp 1, Dept Gen Surg, Jinan 250014, Peoples R China

来源：

EJSO | 2021年 / 47卷 / 07期

基金：

中国国家自然科学基金;

关键词：

Rectum; Gastrointestinal stromal tumor; Surgery; Propensity score matching; SURGICAL-MANAGEMENT; RECURRENCE; SURVIVAL; THERAPY; CANCER; COHORT; RISK;

D O I：

10.1016/j.ejso.2021.01.027

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The surgical approaches and resection extent for rectal gastrointestinal stromal tumors (GISTs) are controversial due to the low incidence of this disease. A multicenter retrospective cohort study was conducted to compare the postoperative and oncologic outcomes of local excision (LE) and radical resection (RR) in patients with low rectal GIST. Patients and methods: The medical records of rectal GIST patients from 11 large-scale medical centers in China (January 2000-December 2019) were reviewed. All patients were divided into either the LE group or the RR group. Propensity score matching (PSM) was conducted to reduce confounders. Results: A total of 280 patients with low rectal GIST were enrolled. After PSM, 144 patients were included (72 in each group). The LE group showed a higher anal preservation rate (100.0% vs. 76.4%, P < 0.001), shorter operation time (77.1 +/- 68.4 min vs. 159.1 +/- 83.6 min, P < 0.001), fewer complications (8.3% vs. 22.2%, P = 0.021) and shorter postoperative hospital stay (4.9 +/- 4.1 d vs. 10.7 +/- 8.1 d, P < 0.001) than the RR group. There was no significant difference in recurrence-free survival (RFS) between the RR and LE groups among patients with tumors <= 2 cm(P = 0.220), and the RR group had a superior RFS than the LE group in patients with tumors >2 cm (P = 0.046). Conclusions: LE resulted in improved postoperative outcomes and comparable oncological safety with a low rectal GIST of <= 2 cm. However, for patients with a low rectal GIST of >2 cm, RR might be a more appropriate option with better RFS. (C) 2021 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：1668 / 1674

页数：7

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