Frequent rectal gastrointestinal stromal tumor recurrences in the imatinib era: Retrospective analysis of an International Patient Registry

Stuart, Emelia; Banerjee, Sudeep; Torre, Jorge de la; Wang, Yu; Scherzer, Norman J.; Burgoyne, Adam M.; Parry, Lisa; Fanta, Paul T.; Ramamoorthy, Sonia; Sicklick, Jason K.

doi:10.1002/jso.25621

Cited by 11 publications

(18 citation statements)

References 21 publications

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“…Tumors with KIT mutations accounted for 93.9% of all the rectal GIST. In the current study, all tumors detected harbored KIT mutations, 82.6% in Exon 11, 13.0% in Exon 9, and 4.4% in Exon 13, and was almost consistent with that of Stuart et al's16 …”

supporting

confidence: 90%

Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis

Ling

Ding

Yang

et al. 2021

Journal of Surgical Oncology

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Background and Objectives: This study aimed to compare outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal gastrointestinal stromal tumors (GIST) patients.Methods: Eighty-five patients with localized rectal GIST were divided into two groups: upfront surgery ± adjuvant imatinib (Group A, n = 33) and the neoadjuvant imatinib + surgery + adjuvant imatinib (Group B, n = 52). Baseline characteristics between groups were controlled for with inverse probability of treatment weighting (IPTW) adjusted analysis. Results:The response rate to neoadjuvant imatinib was 65.9%. After the IPTWadjusted analysis, patients who underwent neoadjuvant therapy had better distant recurrence-free survival (DRFS) and disease-specific survival (DSS) compared with those who underwent upfront surgery (5-year DRFS 97.8 vs. 71.9%, hazard ratio [HR], 0.15; 95% CI, 0.03-0.87; p = 0.03; 5-year DSS 100 vs. 77.1%; HR, 0.11; 95% CI, 0.01-0.92; p = 0.04). While no significant association was found between overall survival (OS) and treatment groups (p = 0.07), 5-year OS was higher for the neoadjuvant group than upfront surgery group (97.8% vs. 71.9%; HR, 0.2; 95% CI, 0.03-1.15). Conclusions:In patients with localized rectal GIST, neoadjuvant imatinib not only shrunk the tumor size but also decreased the risk of metastasis and tumor-related deaths when compared to upfront surgery and adjuvant imatinib alone.

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supporting

confidence: 90%

Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis

Ling

Ding

Yang

et al. 2021

Journal of Surgical Oncology

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“…A higher grade in the Miettinen risk score has also been associated with lower survival rates. 5 14 24 25 In fact, in a retrospective study conducted by Sakin et al, 8 the Kaplan-Meier analysis showed a significantly lower DFS ( p = 0.034) and OS ( p = 0.022) in high-risk patients, compared with their non-high-risk counterparts. Moreover, a study published in 2019 8 reported that high-risk score negatively affected DFS (HR = 5.158; 95% CI 1.418–12.750; p = 0.013).…”

Section: Resultsmentioning

confidence: 98%

“…According to most reports in the literature, older age is considered a poor prognostic factor. 10 14 24 32 33 Additionally, male gender, 9 34 hematochezia at diagnosis, and tumor rupture during surgery 9 34 35 are also clinical predictors of prognosis.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Factors and Management of Colorectal Gastrointestinal Stromal Tumors

Reis

Barbosa

2022

Journal of Coloproctology

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Introduction The gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Even though it can be found in any location of the digestive tract, the colorectal GIST is rare. With this study, we aim to review the current knowledge regarding the prognosis and management of colorectal GIST. Methods A literature search was conducted in PubMed, and 717 articles were collected. After analyzing these studies, 60 articles were selected to use in this review. Results The mitotic index, as well as tumor size and location were identified as good discriminators of prognosis in various studies. Surgery remains the only curative therapy for potentially resectable tumors. However, even after surgical resection, some patients develop disease recurrence and metastasis, especially those with high-risk tumors. Therefore, surgical resection alone might be inadequate for the management of all colorectal GISTs. The discovery of GIST's molecular pathway led to a shift in its therapy, insofar as tyrosine kinase inhibitors became part of the treatment schemes for this tumor, revolutionizing the treatment's outcome and prognosis. Discussion/Conclusion The controversy concerning colorectal GIST prognosis and treatment can be, in part, attributed to the limited number of studies in the literature. In this review, we gathered the most recent knowledge about the prognosis and management of GIST in this rare location and propose two algorithms for its approach. Lastly, we highlight the importance of an individualized approach in the setting of a multidisciplinary team.

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“…In the present study, 5‐year OS was higher than 95%. Finally, Stuart et al 23 have shown that adjuvant therapy with imatinib is associated with improved DFS.…”

Section: Discussionmentioning

confidence: 99%

Is nonanatomic rectal resection a valid therapeutic option for rectal gastrointestinal stromal tumors? A proposed decision algorithm

Romain

Delhorme

Manceau

et al. 2020

Journal of Surgical Oncology

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Background and objectives: The best surgical approach to rectal gastrointestinal stromal tumors (GISTs) is still debated, and both nonanatomic rectal resection (NARR) and anatomic rectal resection (ARR) are applied. The aim of this study was to evaluate the feasibility and oncological outcomes of NARR and ARR for rectal GISTs (R-GISTs). Methods: Through a large French multicentre retrospective study, 35 patients were treated for R-GIST between 2001 and 2013. Patients who underwent NARR and ARR were compared. Results: There were 23 (65.7%) patients in group ARR and 12 (34.3%) in group NARR. Significantly more patients in the group with ARR had a neoadjuvant treatment (86%) with tyrosine kinase inhibitor (TKI) (imatinib) compared to those with NARR (25%) (p < .01). The median preoperative tumor size was significantly different between the groups without and with neoadjuvant TKI: 30 ± 23 mm versus 64 ± 44.4 mm, respectively (p < .001). Overall postoperative morbidity was 20% (n = 7) (26% for ARR vs. 8% for NARR; p = .4). After a median follow-up of 60.2 (3.2-164.3) months, the 5-year disease-free survival rates were 79.5% (confidence interval [CI] 95%: 54-100) for the NARR group and 68% (CI 95%: 46.4-89.7) for the ARR group (p = .697), respectively. Conclusion: The use of NARR for small R-GIST's does not seem to impair the oncological prognosis.

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Frequent rectal gastrointestinal stromal tumor recurrences in the imatinib era: Retrospective analysis of an International Patient Registry

Cited by 11 publications

References 21 publications

Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis

Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis

Prognostic Factors and Management of Colorectal Gastrointestinal Stromal Tumors

Is nonanatomic rectal resection a valid therapeutic option for rectal gastrointestinal stromal tumors? A proposed decision algorithm

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