Microscopically positive margins for primary gastrointestinal stromal tumors: analysis of risk factors and tumor recurrence.
Microscopically positive margins for primary gastrointestinal stromal tumors: analysis of risk factors and tumor recurrence.
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DOI：
10.1016/j.jamcollsurg.2012.05.008
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发表时间：
2012-07
影响因子：
5.2
通讯作者：
DeMatteo, Ronald P.
中科院分区：
文献类型：
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作者：
McCarter, Martin D.;Antonescu, Cristina R.;Ballman, Karla V.;Maki, Robert G.;Pisters, Peter W. T.;Demetri, George D.;Blanke, Charles D.;von Mehren, Margaret;Brennan, Murray F.;McCall, Linda;Ota, David M.;DeMatteo, Ronald P.
对于原发胃肠道间质瘤(GIST)镜检阳性(R1)切除的患者的结果知之甚少，因为现有的回顾系列是由少数患者组成的。这项研究的目的是分析与R1切除相关的因素，并评估使用和不使用伊马替尼的复发风险。本文回顾了来自北美ACOSOG Z9000和Z9001临床试验的819例原发胃肠道间质瘤切除术患者的手术和病理报告，这些临床试验在230个机构进行了伊马替尼佐剂试验。分析患者、肿瘤、手术特点、与R1切除相关的因素和疾病状况。72例(8.8%)患者接受了R1切除，平均随访时间为49个月。影响R1切除的因素包括肿瘤大小(≥)10 cm、直肠位置(直肠)和肿瘤破裂。在R1患者中，疾病复发的风险在很大程度上是由肿瘤破裂引起的。接受胃肠道间质瘤切除的患者无复发生存率在辅助剂伊马替尼或不辅佐伊马替尼(HR=1.095.51，95%CI：0.76，2.99，P=0.2 4)的情况下无显著差异。在819名GIST患者中，约9%的患者接受了R1切除。与R1切除相关的重要因素包括肿瘤大小、≥10 cm、位置和破裂。在中位数为4年的随访中，接受r1和r0切除的患者中，接受伊马替尼治疗或不接受伊马替尼治疗的无复发存活率的差异在统计学上没有统计学意义。
Little is known about the outcome of patients with microscopically positive (R1) resections for primary gastro-intestinal stromal tumors (GISTs), because existing retrospective series are comprised of small numbers of patients. The objective of this study was to analyze factors associated with R1 resection and assess the risk of recurrence with and without imatinib. Operative and pathology reports for 819 patients undergoing resection of primary GIST from North American ACOSOG Z9000 and Z9001 clinical trials at 230 institutions testing adjuvant imatinib after resection of primary GIST were reviewed. Patient, tumor, operative characteristics, factors associated with R1 resections, and disease status were analyzed. Seventy two (8.8%) patients had an R1 resection and were followed for a median of 49 months. Factors associated with R1 resection included tumor size (≥10cm), location (rectum) and tumor rupture. The risk of disease recurrence in R1 patients was driven largely by the presence of tumor rupture. There was no significant difference in recurrence free survival for patients undergoing an R1 vs. R0 resection of GIST with (HR=1.095, 95% CI: 0.66, 1.82, p=0.73) or without (HR=1.51, 95% CI: 0.76, 2.99, p=0.24) adjuvant imatinib. Approximately 9% of 819 GIST patients had an R1 resection. Significant factors associated with R1 resection include tumor size ≥10cm, location and rupture. The difference in recurrence free survival with or without imatinib therapy in those undergoing an R1 vs. R0 resection was not statistically significant at a median follow-up of 4 years.
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影响因子：
--
作者：
Pierie, JPEN;Choudry, U;Ott, MJ
通讯作者：
Ott, MJ
影响因子：
3.8
作者：
Bucher, P;Egger, JF;Morel, P
通讯作者：
Morel, P
影响因子：
9
作者：
Park, Cheol Keun;Lee, Eui Jin;Kim, Kyoung-Mee
通讯作者：
Kim, Kyoung-Mee
影响因子：
2.6
作者：
Gouveia, Antonio M.;Pimenta, Amadeu P.;Lopes, Jose M.
通讯作者：
Lopes, Jose M.
影响因子：
3.8
作者：
Hinz, S.;Pauser, U.;Faendrich, F.
通讯作者：
Faendrich, F.