Ten-Year Survivorship in Patients with Metastatic Gastrointestinal Stromal Tumors.
Ten-Year Survivorship in Patients with Metastatic Gastrointestinal Stromal Tumors.
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DOI：
10.1245/s10434-022-12063-5
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发表时间：
2022-10
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
发生转移性胃肠道间质瘤（mGIST）的患者具有异质的疾病生物学和肿瘤学结果；预后因素的特征不完全。我们试图评估酪氨酸激酶抑制剂 (TKI) 治疗时代 10 年转移生存的预测因素。我们回顾了 2003 年至 2019 年在我们的综合癌症中心接受治疗的 mGIST 患者，仅包括死亡或随访 10 年的患者。通过逻辑回归评估十年生存率。我们确定了 109 名 mGIST 诊断时中位年龄为 57 岁的患者。 57% (n = 62) 的患者存在同步性疾病；肝脏（n = 48，44%）、腹膜（n = 40，37%）和肝脏+腹膜（n = 18，17%）是最常见的部位。四十六名 (42%) 患者是 10 年 mGIST 幸存者。 mGIST 诊断后，53% (n = 58) 的患者在 2 年内出现影像学进展，16% (n = 17) 的患者在 2-5 年内出现进展，16% (n = 17) 的患者在 5-10 年出现进展，中位生存期分别为 32、76 和 173 个月。 17 名 (16%) 患者 10 年后病情未见进展。 52 名 (47%) 患者接受了转移切除术，这与改善无进展生存期相关（风险比 0.63，p = 0.04）。在经历疾病进展的患者中，与 10 年生存率独立相关的因素是年龄（优势比 [OR] 0.96，p = 0.03）和疾病进展时间（OR 1.71/年，p < 0.001）。在 TKI 时代，mGIST 可以实现十年生存，并且与更年轻的年龄和更长的首次进展时间相关，而转移瘤切除术与更长的首次进展时间相关。转移瘤切除术在治疗接受 TKI 治疗的疾病进展患者中的作用值得进一步研究。
Patients developing metastatic gastrointestinal stromal tumors (mGIST) have heterogenous disease biology and oncologic outcomes; prognostic factors are incompletely characterized. We sought to evaluate predictors of 10-year metastatic survivorship in the era of tyrosine kinase inhibitor (TKI) therapy. We reviewed patients with mGIST treated at our Comprehensive Cancer Center from 2003 to 2019, including only patients with either mortality or 10 years of follow-up. Ten-year survivorship was evaluated with logistic regression. We identified 109 patients with a median age of 57 years at mGIST diagnosis. Synchronous disease was present in 57% (n = 62) of patients; liver (n = 48, 44%), peritoneum (n = 40, 37%), and liver + peritoneum (n = 18, 17%) were the most common sites. Forty-six (42%) patients were 10-year mGIST survivors. Following mGIST diagnosis, radiographic progression occurred within 2 years in 53% (n = 58) of patients, 2–5 years in 16% (n = 17), and 5–10 years in 16% (n = 17), with median survival of 32, 76, and 173 months, respectively. Seventeen (16%) patients had not progressed by 10 years. Fifty-two (47%) patients underwent metastasectomy, which was associated with improved progression-free survival (hazard ratio 0.63, p = 0.04). In patients experiencing progression, factors independently associated with 10-year survivorship were age (odds ratio [OR] 0.96, p = 0.03) and time to progression (OR 1.71/year, p < 0.001). Ten-year survivorship is achievable in mGIST in the era of TKIs and is associated with younger age and longer time to first progression, while metastasectomy is associated with longer time to first progression. The role of metastasectomy in the management of patients with disease progression receiving TKI therapy merits further study.
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影响因子：
0.9
作者：
Patnaik, Sujata;Jyotsnarani, Yarlagadda;Rammurti, Susarla
通讯作者：
Rammurti, Susarla
影响因子：
2.9
作者：
Sutton, Thomas L.;Walker, Brett S.;Mayo, Skye C.
通讯作者：
Mayo, Skye C.
影响因子：
3.1
作者：
Hompland, Ivar;Bruland, Oyvind Sverre;Boye, Kjetil
通讯作者：
Boye, Kjetil
DOI：
10.1002/bjs.10809
发表时间：
2018-07
期刊：
The British journal of surgery
影响因子：
--
作者：
van der Graaf WTA;Tielen R;Bonenkamp JJ;Lemmens V;Verhoeven RHA;de Wilt JHW
通讯作者：
de Wilt JHW
影响因子：
--
作者：
Call, Jerry W.;Wang, Yu;Heinrich, Michael C.
通讯作者：
Heinrich, Michael C.