Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours
Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours
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DOI：
10.1002/bjs.5350
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发表时间：
2006-07-01
影响因子：
9.6
通讯作者：
Nilsson, B.
中科院分区：
文献类型：
--
作者：
Bumming, P.;Ahlman, H.;Nilsson, B.
背景：这项基于人群的回顾性研究是在引入伊马替尼之前进行的，目的是评估手术在胃肠道间质瘤（gist）患者中的作用，并阐明哪些亚组可能从辅助治疗中受益。方法：对259例经临床诊断为胃肠道间质瘤的患者进行分析。进行单因素和多因素分析以确定疾病复发和生存的预测因素。结果：48例高危胃肠道间质瘤患者中30例和所有明显恶性肿瘤患者在完全切除（R0）后肿瘤复发。38例首次复发中有34例发生在手术后36个月内。术后72个月无复发。60例高风险肿瘤患者中48例（80%）实现R0切除术，与肿瘤复发死亡风险降低显著相关（P = 0.008）。结论：手术切除是否完整是影响高危gist患者预后的独立因素。对于接受R0切除且无肿瘤间隔小于6年的高风险或明显恶性gist患者，推荐使用伊马替尼进行一段时间的辅助治疗。
Background: The aim of this retrospective population-based study, which was conducted before the introduction of imatinib, was to evaluate the role of surgery in patients with gastrointestinal stromal tumours (GISTs) and clarify which subgroups might benefit from adjuvant treatment.Methods: Two hundred and fifty-nine patients with clinically detected GISTs were studied. Univariate and multivariate analyses were performed to identify predictors for recurrent disease and survival.Results: Thirty of 48 patients with high-risk GISTs and all of those with overtly malignant tumours developed recurrent tumour after complete (R0) resection. Thirty-four of 38 first recurrences occurred within 36 months of surgery. No recurrence was observed after 72 months. R0 resection, achieved in 48 (80 per cent) of 60 patients with high-risk tumours, was significantly associated with a decreased risk of death from tumour recurrence (P = 0.008).Conclusion: Completeness of surgical resection is an independent prognostic factor in patients with high-risk GISTs. A period of adjuvant treatment with imatinib is recommended in patients with high-risk or overtly malignant GISTs who have undergone R0 resection and have a tumour-free interval of less than 6 years.