Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study
Abstract Background Preoperative imatinib mesylate therapy for gastrointestinal stromal tumors (GISTs) is controversial. This study aimed to explore the clinical efficacy and optimal duration of preoperative imatinib mesylate (IM) therapy in patients with locally advanced and recurrent/metastatic GI...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | http://link.springer.com/article/10.1186/s12957-020-01840-9 |
| _version_ | 1818065205320482816 |
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| author | Jing Qi He-Li Liu Feng Ren Sheng Liu Wei Shi Wei-Hang Liu Gao-Qiang Cai Guo-Qing Liao |
| author_facet | Jing Qi He-Li Liu Feng Ren Sheng Liu Wei Shi Wei-Hang Liu Gao-Qiang Cai Guo-Qing Liao |
| author_sort | Jing Qi |
| collection | DOAJ |
| description | Abstract Background Preoperative imatinib mesylate therapy for gastrointestinal stromal tumors (GISTs) is controversial. This study aimed to explore the clinical efficacy and optimal duration of preoperative imatinib mesylate (IM) therapy in patients with locally advanced and recurrent/metastatic GISTs. Methods We retrospectively examined patients who received preoperative imatinib mesylate therapy from January 2013 to December 2018 at Xiangya Hospital, Central South University and the Second Xiangya Hospital of Central South University, China. Clinical data, including the results of tests for mutations in KIT and PDGFR, findings from regularly conducted re-examinations, abdominal-enhanced computed tomography/magnetic resonance imaging data, responses to imatinib, progression-free survival, and overall cancer-specific survival, were recorded. Results A total of 25 patients were enrolled in our study, including 18 with a locally advanced GIST and 7 with recurrent or metastatic GISTs. Their ages ranged from 22 to 70 years (M:F = 1.6:0.9), with a mean age of 50.48 ± 12.51 years. The tumor locations included the stomach (56.0%), rectum (16.0%), enterocoelic/retroperitoneal sites (12.0%), and the small intestine (12.0%). Based on testing for mutations in KIT and PDGFR, 22 patients received 400 mg/day KIT, and 3 patients received 600 mg/day PDGFR. The median duration of preoperative IM therapy was 8.96 ± 4.81 months, ranging from 3 to 26 months. According to the Choi criteria, 24 patients achieved a partial response (PR), and 1 patient had stable disease (SD). All patients underwent surgery after preoperative IM therapy, and no postoperative complications appeared. The 2-year PFS and 5-year PFS were 92% and 60%, respectively, and the total 5-year cancer-specific survival (CSS) was 92%. Conclusion Preoperative imatinib therapy is feasible for locally advanced and recurrent/metastatic GISTs and can effectively shrink the tumor size, allow organ sparing, and avoid extensive organ resection. Moreover, the optimal duration of preoperative IM therapy in patients with locally advanced and recurrent/metastatic GISTs was 8.96 ± 4.81 months, ranging from 3 to 26 months, and gastric GISTs had a better response to preoperative IM therapy than did non-gastric GISTs. |
| first_indexed | 2024-12-10T14:48:11Z |
| format | Article |
| id | doaj.art-8ca5251012b2484988a0638a7c5f6c21 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-10T14:48:11Z |
| publishDate | 2020-04-01 |
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| series | World Journal of Surgical Oncology |
| spelling | doaj.art-8ca5251012b2484988a0638a7c5f6c212022-12-22T01:44:31ZengBMCWorld Journal of Surgical Oncology1477-78192020-04-0118111110.1186/s12957-020-01840-9Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective studyJing Qi0He-Li Liu1Feng Ren2Sheng Liu3Wei Shi4Wei-Hang Liu5Gao-Qiang Cai6Guo-Qing Liao7Department of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityDepartment of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityDepartment of Geriatric Surgery, The Second Xiangya Hospital, Central South UniversityDepartment of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityDepartment of Radiology, Xiangya Hospital Central South UniversityDepartment of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityDepartment of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityDepartment of Gastrointestinal Surgery, Xiangya Hospital of Central South UniversityAbstract Background Preoperative imatinib mesylate therapy for gastrointestinal stromal tumors (GISTs) is controversial. This study aimed to explore the clinical efficacy and optimal duration of preoperative imatinib mesylate (IM) therapy in patients with locally advanced and recurrent/metastatic GISTs. Methods We retrospectively examined patients who received preoperative imatinib mesylate therapy from January 2013 to December 2018 at Xiangya Hospital, Central South University and the Second Xiangya Hospital of Central South University, China. Clinical data, including the results of tests for mutations in KIT and PDGFR, findings from regularly conducted re-examinations, abdominal-enhanced computed tomography/magnetic resonance imaging data, responses to imatinib, progression-free survival, and overall cancer-specific survival, were recorded. Results A total of 25 patients were enrolled in our study, including 18 with a locally advanced GIST and 7 with recurrent or metastatic GISTs. Their ages ranged from 22 to 70 years (M:F = 1.6:0.9), with a mean age of 50.48 ± 12.51 years. The tumor locations included the stomach (56.0%), rectum (16.0%), enterocoelic/retroperitoneal sites (12.0%), and the small intestine (12.0%). Based on testing for mutations in KIT and PDGFR, 22 patients received 400 mg/day KIT, and 3 patients received 600 mg/day PDGFR. The median duration of preoperative IM therapy was 8.96 ± 4.81 months, ranging from 3 to 26 months. According to the Choi criteria, 24 patients achieved a partial response (PR), and 1 patient had stable disease (SD). All patients underwent surgery after preoperative IM therapy, and no postoperative complications appeared. The 2-year PFS and 5-year PFS were 92% and 60%, respectively, and the total 5-year cancer-specific survival (CSS) was 92%. Conclusion Preoperative imatinib therapy is feasible for locally advanced and recurrent/metastatic GISTs and can effectively shrink the tumor size, allow organ sparing, and avoid extensive organ resection. Moreover, the optimal duration of preoperative IM therapy in patients with locally advanced and recurrent/metastatic GISTs was 8.96 ± 4.81 months, ranging from 3 to 26 months, and gastric GISTs had a better response to preoperative IM therapy than did non-gastric GISTs.http://link.springer.com/article/10.1186/s12957-020-01840-9Gastrointestinal stromal tumorPreoperative treatmentImatinib mesylateRetrospective study |
| spellingShingle | Jing Qi He-Li Liu Feng Ren Sheng Liu Wei Shi Wei-Hang Liu Gao-Qiang Cai Guo-Qing Liao Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study World Journal of Surgical Oncology Gastrointestinal stromal tumor Preoperative treatment Imatinib mesylate Retrospective study |
| title | Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study |
| title_full | Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study |
| title_fullStr | Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study |
| title_full_unstemmed | Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study |
| title_short | Preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumors: a retrospective study |
| title_sort | preoperative adjuvant therapy for locally advanced and recurrent metastatic gastrointestinal stromal tumors a retrospective study |
| topic | Gastrointestinal stromal tumor Preoperative treatment Imatinib mesylate Retrospective study |
| url | http://link.springer.com/article/10.1186/s12957-020-01840-9 |
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