Gastrointestinal Stromal Tumors

Hohenberger, Peter; Montemurro, Michael; Raut, Chandrajit P.; Rutkowski, Piotr

doi:10.1159/000493934

Cited by 4 publications

(2 citation statements)

References 13 publications

(19 reference statements)

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“…9,24 The neoadjuvant strategy is especially attractive in surgically demanding tumor sites, thus it is more commonly used in rectal GIST patients than in gastric GIST patients. 25 In the imatinib era, the literature on GIST outcomes from different sites has revealed no survival differences between gastric GIST and rectal GIST patients. 26 This may indirectly support the hypothesis that improved prognosis of rectal GIST is caused not only by imatinib itself but also by time of medication.…”

Section: Discussionmentioning

confidence: 99%

“…In the pre‐imatinib era, rectal GIST patients had a significantly worse prognosis than gastric GIST 9,24 . The neoadjuvant strategy is especially attractive in surgically demanding tumor sites, thus it is more commonly used in rectal GIST patients than in gastric GIST patients 25 . In the imatinib era, the literature on GIST outcomes from different sites has revealed no survival differences between gastric GIST and rectal GIST patients 26 .…”

Section: Discussionmentioning

confidence: 99%

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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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