Prognostic factors after imatinib secondary resistance: survival analysis in patients with unresectable and metastatic gastrointestinal stromal tumors.
Prognostic factors after imatinib secondary resistance: survival analysis in patients with unresectable and metastatic gastrointestinal stromal tumors.
复制标题
伊马替尼继发耐药后的预后因素：不可切除和转移性胃肠道间质瘤患者的生存分析。
DOI：
10.1007/s10147-015-0903-7
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Hirota S.
中科院分区：
文献类型：
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作者：
Kanda T;Ishikawa T;Kosugi S-I;Ueki K;Naito T;Wakai T;Hirota S.
背景接受伊马替尼治疗的胃肠道间质瘤（GIST）患者在治疗的晚期表现出耐药性。本研究的目的是确定伊马替尼继发性耐药（ISR）的外观后的生存率，并确定预后factors.MethodsEligible是不可切除和转移性胃肠道间质瘤谁被诊断为ISR和/或在我们的机构进行ISR治疗的患者在2001年和2012年之间。共入组48例患者，回顾性分析总生存期。采用考克斯比例风险模型分析影响预后的因素。中位随访时间为58 months.Results48例ISR患者中有41例死亡，其中39例死于胃肠道间质瘤。48例患者的1年、3年和5年总生存率分别为64.6%、32.8%和20.4%，中位生存时间为22个月。确定的有利的独立预后因素是伊马替尼一线治疗的无进展生存期长（P= 0.04），小直径的进展性疾病（PD）（P= 0.02），和手术切除PD（P= 0.01）。结论在选定的情况下，手术切除PD可以改善预后ISR患者接受GIST治疗。
BackgroundPatients undergoing imatinib therapy for gastrointestinal stromal tumors (GISTs) show drug resistance during treatment in the late stages. The aims of this study were to determine survival after the appearance of imatinib secondary resistance (ISR) and to identify the prognostic factors.MethodsEligible were patients with unresectable and metastatic GISTs who were diagnosed with ISR and/or underwent treatment for ISR in our institution between 2001 and 2012. A total of 48 patients were enrolled and overall survival was retrospectively analyzed. The Cox proportional hazards model was used to identify the independent prognostic factors. Median follow-up time was 58 months.ResultsAs of the cutoff date, 41 of the 48 patients with ISR had died, of which 39 died of GISTs. The overall 1-, 3-, and 5-year survival rates of the 48 patients were 64.6, 32.8, and 20.4 %, respectively, and median survival time was 22 months. The favorable independent prognostic factors identified were long progression-free survival in first-line imatinib therapy (P= 0.04), small diameter of progressive disease (PD) (P= 0.02), and surgical resection of PD (P= 0.01).ConclusionSurgical resection of PD in selected cases could improve prognosis in ISR patients undergoing GIST treatment.