Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours

Bümming, Per; Ahlman, Håkan; Andersson, Jan-Erik; Meis‐Kindblom, Jeanne M.; Kindblom, Lars‐Gunnar; Nilsson, Bengt

doi:10.1002/bjs.5350

Cited by 52 publications

(43 citation statements)

References 24 publications

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“…In the multivariate analysis, only the presence of macroscopic residual tumor (R2) was significantly associated (p=0.013) with shorter DSS (Gouveia, Pimenta et al 2008). The DSS and RFS values in our patients fit with results published in other studies (DeMatteo, Lewis et al 2000;Crosby, Catton et al 2001;Fujimoto, Nakanishi et al 2003;Langer, Gunawan et al 2003;Lin, Huang et al 2003;Wong, Young et al 2003;Bucher, Taylor et al 2004;Bucher, Egger et al 2006;Bumming, Ahlman et al 2006). The recurrence rate was significantly lower in R0 cases, but in multivariate analysis only R2 resection was significantly associated with shorter survival of patients.…”

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confidence: 88%

“…In addition, some of these reported results may be biased by the effect of adjuvant treatment performed in advanced or incompletely removed GISTs (He, Wang et al 1988;DeMatteo, Lewis et al 2000). Other authors suggest that R0 resections may influence the prognosis of patients (Lehnert 1998;Pidhorecky, Cheney et al 2000;Langer, Gunawan et al 2003;Lin, Huang et al 2003;Wu, Langerman et al 2003;Yan, Marchettini et al 2003;Bucher, Egger et al 2006;Bumming, Ahlman et al 2006;Hinz, Pauser et al 2006;Ahmed, Welch et al 2008); however, these results can also be influenced by the number of incomplete resections in GISTs of high biological risk (Lin, Huang et al 2003). Similar to the reports of DeMatteo et al e Pierie et al (Pierie, Choudry et al 2001), our own results reinforce that complete macroscopic resection of GISTs has a positive impact in the prognosis, being significantly shorter the specific survival of patients with R2 tumor margin status.…”

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confidence: 99%

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Surgical Treatment of Gastrointestinal Stromal Tumors (GISTs)

Gouveia¹,

Lopes²

2012

Gastrointestinal Stromal Tumor

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confidence: 88%

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Surgical Treatment of Gastrointestinal Stromal Tumors (GISTs)

Gouveia¹,

Lopes²

2012

Gastrointestinal Stromal Tumor

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“…Our study consists of a single-centre, consecutive pilot series of 23 patients with high-risk GIST who have been treated with adjuvant imatinib (400 mg day À1 ) for 1 year after R0 resection. These cases are compared with historical controls from a previous population-based series (Nilsson et al, 2005;Bumming et al, 2006) with matched risk scores with respect to tumour size and maximal proliferative activity with Ki67 antibodies. …”

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Adjuvant imatinib treatment improves recurrence-free survival in patients with high-risk gastrointestinal stromal tumours (GIST)

et al. 2007

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Palliative imatinib treatment has dramatically improved survival in patients with malignant gastrointestinal stromal tumours, particularly in patients with tumours harbouring activating KIT mutations. To evaluate the effectiveness of adjuvant imatinib after radical surgery, a consecutive series of patients with high-risk tumours (n ¼ 23) was compared with historic controls (n ¼ 48) who were treated with surgery alone. The mean follow-up period was over 3 years in both groups. Only 1 out of 23 patients (4%) in the adjuvant treatment group developed recurrent disease compared to 32 out of 48 patients (67%) in the control group. This preliminary study indicates that 1 year of adjuvant treatment with imatinib dramatically improves recurrence-free survival. Confirmation of these findings awaits the results of ongoing randomised studies. The survival of patients with metastatic and inoperable malignant gastrointestinal stromal tumours (GIST), particularly those whose tumours have KIT exon 11 mutations, has improved dramatically since the introduction of imatinib mesylate into treatment protocols (Verweij et al, 2004). The role of adjuvant imatinib treatment in GIST, however, is unclear and is currently being investigated in ongoing trials. Four such studies, including patients have undergone radical (R0) surgery, are currently being conducted with different inclusion criteria in terms of malignant potential according to the consensus grading system of Fletcher et al (2002). ACOSOG Z9000 addresses treatment with imatinib (400 mg day À1 p.o.(orally)) for 1 year in patients with high-risk GIST with no control arm, while ACOSOG Z9001 compares imatinib treatment with placebo in patients with tumours X3 cm (low, intermediate, and high-risk tumours). EORTC 62024 is designed for patients with intermediate-and high-risk GIST treated with imatinib (400 mg day À1 p.o.(orally)) vs placebo for 2 years. Finally, SSG XVIII includes high-risk GIST treated with imatinib (400 mg day À1 p.o.(orally)) for either 1 or 3 years. The purpose of this study was to report our experience with adjuvant imatinib, while awaiting the results of ongoing multicentre trials. Our study consists of a single-centre, consecutive pilot series of 23 patients with high-risk GIST who have been treated with adjuvant imatinib (400 mg day À1 ) for 1 year after R0 resection. These cases are compared with historical controls from a previous population-based series (Nilsson et al, 2005;Bumming et al, 2006) with matched risk scores with respect to tumour size and maximal proliferative activity with Ki67 antibodies. MATERIALS AND METHODSThe pilot adjuvant imatinib study group consisted of 23 consecutive patients (11 women and 12 men; mean age 56 years, range 21 -82 years) with high-risk GIST diagnosed between February 2001 and June 2005. The mean tumour size was 9.4 cm (s.d. ¼ 7.7, range 2 -35 cm), and the mean Ki67 max% (maximum percentage of cells positive with Ki67 immunostains) was 7.0 (s.d. 5.0, range 2 -10%). These patients received adjuvant imatinib (400 mg day...

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“…The great majority of published series are smaller than 50 cases, therefore, the series of Ahmed, An, Hassan, Martin and Wong with casuisticals higher to 100 cases (Cao et al, 2010;Ahmed et al, 2008;An et al, 2007;Hassan et al, 2008;Manrique et al, 2012;Martín et al, 2005;Wong et al, 2003) are noteworthy, and those from DeMatteo et al, Bümming et al (2006) and Rutowsky et al (2007) with casuisticals over than 200 treated patients (Bellorin et al, 2014;Bümming et al;DeMatteo et al;Rutkowski et al).…”

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confidence: 99%

Gastrointestinal Stromal Tumors (GISTs): Single Center Experience Observed in a Small Series of Cases

Manterola

Otzen

2016

Int. J. Morphol.

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SUMMARY:Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms developing in the stomach. Usually detected incidentally, they can be single or multiple. The aim of this study is to report the results of surgery in the treatment of GISTs in terms of postoperative morbidity (POM) and recurrence. Case series. Patients surgically treated by GISTs at the Clínica Mayor of Temuco, Chile, between 2008 and 2015 were included. The preoperative study consisted in general diagnostic tests, endoscopy and abdominal CT-Scan. The outcome variable was POM, measured at 30 days postoperatively. Other variables of interest were: surgical time, hospital stay, mortality and recurrence. Minimum follow-up time was 12 months. Descriptive statistics were used. Four patients with GISTs were operated in the study period. Median age was 67 years, and 50 % of the patients were female. The median time of symptoms was 6 months. Excision of the lesion was performed in all cases with a median surgical time of 129 min. POM was 25 % (one case developed a seroma of the surgical wound), grade I of Clavien & Dindo proposal. Hospital stay was 4 day in all cases and no operative mortality was reported. With a median follow-up of 24 months there was not evidenced of recurrence. Although the results were positive, it is worth mentioning that this was a very small number of cases, therefore, they should be considered with caution.

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Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours

Cited by 52 publications

References 24 publications

Surgical Treatment of Gastrointestinal Stromal Tumors (GISTs)

Surgical Treatment of Gastrointestinal Stromal Tumors (GISTs)

Adjuvant imatinib treatment improves recurrence-free survival in patients with high-risk gastrointestinal stromal tumours (GIST)

Gastrointestinal Stromal Tumors (GISTs): Single Center Experience Observed in a Small Series of Cases

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