Gastric GIST: A single institutional retrospective experience with surgical treatment for primary disease
Gastric GIST: A single institutional retrospective experience with surgical treatment for primary disease
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DOI：
10.1016/j.ejso.2007.02.009
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发表时间：
2007-10-01
期刊：
影响因子：
3.8
通讯作者：
Kim, S.
中科院分区：
文献类型：
--
作者：
An, J. Y.;Choi, M. G.;Kim, S.
目的：由于胃GIST表现出不同的临床行为，我们回顾了手术治疗和甲磺酸伊马替尼治疗晚期疾病后原发性胃GIST的经验。方法：1995年12月至2005年12月期间，111名接受原发性胃GIST手术治疗的患者纳入本研究。根据风险评估分类对患者进行分组，评估临床病理特征、肿瘤复发和患者生存情况。结果：极低风险组1例，低风险组35例，中危组31例，高危组44例。所有极低、低和中危 GIST 患者以及 70% 的高危 GIST 患者均接受了 RO 切除。虽然极低、低和中等风险 GIST 患者没有复发或转移，但高风险 GIST 患者中有 23% 在诊断时显示远处转移，其中 35% 在 RO 切除后出现复发。高危患者的总体5年生存率为77.1%。 19 名患者因切除不完全或复发而接受甲磺酸伊马替尼治疗； 7 名局部肿瘤对照的 CT 扫描中没有可测量病变的患者在甲磺酸伊马替尼治疗后显示肿瘤没有进展，然而，12 名具有可测量病变的患者在治疗后表现出不同的临床病程。 19例甲磺酸伊马替尼治疗患者的总体5年生存率为80.0%。结论：极低、低、中危胃GIST临床结局良好，而高危胃GIST复发率高，结局较差。完全切除是治愈最重要的治疗方法；然而，甲磺酸伊马替尼治疗可能会改善转移性或复发性胃 GIST 患者的临床结果。 (C) 2007 Elsevier Ltd. 保留所有权利。
Aims: Because gastric GISTs show variable clinical behavior, we reviewed our experience with primary gastric GISTs after surgical treatment and imatinib mesylate treatment for advanced disease.Methods: Between December 1995 and December 2005, 111 patients who underwent surgical treatment for primary gastric GISTs were enrolled in this study. Patients were grouped according to the risk assessment classification, and clinicopathological features, tumor recurrence and patient survival were assessed.Results: One patient was included in the very low risk group, 35 in the low risk group, 31 in the intermediate risk group and 44 in the highrisk group. All patients with very low, low and intermediate risk GISTs and 70% of patients with high risk GISTs underwent RO resection. While there was no recurrence or metastasis in patients with very low, low and intermediate risk GISTs, 23% of those with high risk GISTs showed a distant metastasis at diagnosis and 35% of these patients had a recurrence after RO resection. The overall 5-year survival rate of the high risk patients was 77.1 %. Nineteen patients received imatinib mesylate therapy due to an incomplete resection or recurrence; 7 with no measurable lesion at the CT scan by a local tumor control showed no tumor progression after imatinib mesylate therapy, however, 12 patients with measurable lesions showed variable clinical courses after treatment. The overall 5-year survival rate of 19 patients with imatinib mesylate treatment was 80.0%.Conclusions: The clinical outcome of the very low, low and intermediate risk gastric GISTs was excellent, while high risk gastric GISTs had a high rate of recurrence and therefore a less favorable outcome. A complete resection is the most important treatment for cure; however imatinib mesylate treatment may improve the clinical outcome of the patients with metastatic or recurrent gastric GISTs. (C) 2007 Elsevier Ltd. All rights reserved.