TY - JOUR
T1 - Outcome Following Surgical Therapy for Gastrointestinal Stromal Tumors
AU - Gupta, Maneesh
AU - Sheppard, Brett C.
AU - Corless, Christopher L.
AU - MacDonell, Karen R.
AU - Blanke, Charles D.
AU - Billingsley, Kevin
PY - 2006/9
Y1 - 2006/9
N2 - We have pursued an approach of complete resection for patients with gastrointestinal stromal tumors (GISTs), including multivisceral resection, for patients with disease involving adjacent organs. We have also extended the limits of resection to include patients with metastatic disease who were treated with imatinib mesylate. The aim of this study is to report the outcomes and prognostic factors associated with this clinical approach. Study subjects were identified using the pathology database at our institution; for inclusion in the study group, patients must have undergone surgical resection for a KIT-positive gastrointestinal stromal tumor between January 1992 and March 2004. We calculated survival by using the Kaplan-Meier method. Univariate and multivariate analysis was performed using log-rank analysis and the Cox proportional hazards model. Thirty-four patients met the study criteria. Fifty-nine percent of patients had GISTs of gastric origin, 20.6% had duodenal GISTs, and the remainder was comprised of a variety of other sites. Twenty-two (64.7%) patients underwent single-organ resection, and 12 patients (35.3%) underwent multivisceral resection. Estimated actuarial survival at 5 years was 65.2%. Seven patients (five patients with metastases, one patient with locally advanced disease, and one patient with organ-confined disease) received imatinib mesylate. Independent predictors of poor survival included incomplete resection, metastatic disease at presentation, and high mitotic index. Mitotic index and the presence of metastases remain the primary predictors of postoperative survival. Complete surgical resection, even if multivisceral resection is required, is associated with improved survival.
AB - We have pursued an approach of complete resection for patients with gastrointestinal stromal tumors (GISTs), including multivisceral resection, for patients with disease involving adjacent organs. We have also extended the limits of resection to include patients with metastatic disease who were treated with imatinib mesylate. The aim of this study is to report the outcomes and prognostic factors associated with this clinical approach. Study subjects were identified using the pathology database at our institution; for inclusion in the study group, patients must have undergone surgical resection for a KIT-positive gastrointestinal stromal tumor between January 1992 and March 2004. We calculated survival by using the Kaplan-Meier method. Univariate and multivariate analysis was performed using log-rank analysis and the Cox proportional hazards model. Thirty-four patients met the study criteria. Fifty-nine percent of patients had GISTs of gastric origin, 20.6% had duodenal GISTs, and the remainder was comprised of a variety of other sites. Twenty-two (64.7%) patients underwent single-organ resection, and 12 patients (35.3%) underwent multivisceral resection. Estimated actuarial survival at 5 years was 65.2%. Seven patients (five patients with metastases, one patient with locally advanced disease, and one patient with organ-confined disease) received imatinib mesylate. Independent predictors of poor survival included incomplete resection, metastatic disease at presentation, and high mitotic index. Mitotic index and the presence of metastases remain the primary predictors of postoperative survival. Complete surgical resection, even if multivisceral resection is required, is associated with improved survival.
KW - Gastrointestinal stromal tumors
KW - KIT
KW - gastrointestinal tract
KW - imatinib mesylate
UR - http://www.scopus.com/inward/record.url?scp=33748457495&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33748457495&partnerID=8YFLogxK
U2 - 10.1016/j.gassur.2006.05.014
DO - 10.1016/j.gassur.2006.05.014
M3 - Article
C2 - 16966028
AN - SCOPUS:33748457495
SN - 1091-255X
VL - 10
SP - 1099
EP - 1105
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 8
ER -