Surgical management of rectal gastrointestinal stromal tumors
Surgical management of rectal gastrointestinal stromal tumors
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DOI：
10.1002/jso.23223
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发表时间：
2013-03-01
影响因子：
2.5
通讯作者：
de Wilt, Johannes H. W.
中科院分区：
文献类型：
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作者：
Tielen, Ronald;Verhoef, Cornelis;de Wilt, Johannes H. W.
背景5%的胃肠道间质瘤（GIST）主要位于直肠。我们在一项多中心回顾性系列研究中分析了直肠GIST的综合治疗结果。方法所有手术治疗的直肠GIST患者均来自荷兰的四个专业中心。主要终点为无病生存期（DFS）和总生存期（OS）。结果32例直肠GISTs患者，男22例，女10例。22例患者在术前接受伊马替尼治疗，中位时间为9个月（范围253个月）（第1组）。10例患者因肿瘤体积小或缺乏可用性而未接受伊马替尼治疗（第2组）。第1组治疗前中位肿瘤大小为9.3（范围617）cm，第2组中位肿瘤大小为6（范围414）cm。第1组中17/22例（77%）患者可以完全切除，第2组中7/10例（70%）患者可以完全切除。组1未达到中位DFS，而组2为36个月。两组均未达到中位OS。结论术前伊马替尼可使第1组肿瘤缩小。然而，它并没有导致不太广泛的手术。在术前和术后接受伊马替尼治疗的患者中，DFS较长，对OS无影响。J. Surg. Oncol. 2013;107：320323. (c)2012 Wiley Periodicals，Inc.
Background Five percent of gastrointestinal stromal tumors (GISTs) are primarily localized in the rectum. We analyzed the outcome of multimodality treatment for rectal GIST in a multicenter retrospective series. Methods All surgically treated patients with a rectal GIST were identified from four specialized centers in the Netherlands. Primary endpoints were disease-free survival (DFS) and overall survival (OS). Results Thirty-two patients (22 men and 10 women) with rectal GISTs were identified. Twenty-two patients received imatinib before surgery for a median of 9 (range 253) months (Group 1). Ten patients received no imatinib because of small tumor size or lack of availability (Group 2). Median tumor size before treatment was 9.3 (range 617) cm in Group 1 and median 6 (range 414) cm in Group 2. A complete resection was possible in 17/22 (77%) patients in Group 1 versus 7/10 (70%) in Group 2. Median DFS was not reached in Group 1, while it was 36 months in Group 2. Median OS was not reached in both groups. Conclusions Preoperative imatinib leads to downsizing of the tumors in Group 1. However, it has not led to less extensive surgery. The DFS is longer in patients treated with pre- and post-operative imatinib, without an effect on OS. J. Surg. Oncol. 2013;107:320323. (c) 2012 Wiley Periodicals, Inc.