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Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center

OBJECTIVES: Gastrointestinal stromal tumor (GIST) liver metastasis (GLM) is a special subset of advanced GIST, because its lesions are easier to define and assess. We aim to determine the role of liver metastasectomy for patients with GLM in the era of tyrosine kinase inhibitor (TKI) therapy. METHOD...

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Autores principales: Xiao, Binyi, Peng, Jianhong, Tang, Jinghua, Zhang, Rongxin, Li, Cong, Lin, Junzhong, Ding, Peirong, Wan, Desen, Pan, Zhizhong, Wu, Xiaojun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257109/
https://www.ncbi.nlm.nih.gov/pubmed/30538560
http://dx.doi.org/10.2147/CMAR.S187061
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author Xiao, Binyi
Peng, Jianhong
Tang, Jinghua
Zhang, Rongxin
Li, Cong
Lin, Junzhong
Ding, Peirong
Wan, Desen
Pan, Zhizhong
Wu, Xiaojun
author_facet Xiao, Binyi
Peng, Jianhong
Tang, Jinghua
Zhang, Rongxin
Li, Cong
Lin, Junzhong
Ding, Peirong
Wan, Desen
Pan, Zhizhong
Wu, Xiaojun
author_sort Xiao, Binyi
collection PubMed
description OBJECTIVES: Gastrointestinal stromal tumor (GIST) liver metastasis (GLM) is a special subset of advanced GIST, because its lesions are easier to define and assess. We aim to determine the role of liver metastasectomy for patients with GLM in the era of tyrosine kinase inhibitor (TKI) therapy. METHODS: We reviewed patients with metastatic GIST who received surgery or other treatments in Sun Yat-sen University Cancer Center between January 1991 and December 2017. Patients with metastases confined to the liver and with no previous metastasis to other locations were included into the study and were classified into surgical and non-surgical groups. All patients received 400 mg/d imatinib after the operation. We compared progression-free survival (PFS) and overall survival (OS) between the two groups. RESULTS: A total of 102 patients were included into the study. Of them, 21 (20.1%) underwent surgery for liver metastases and 81 (79.9%) received TKI therapy alone. During the operation, six patients received radiofrequency ablation for suspicious or unresectable lesions. Three-year PFS rate was 77.5% in the surgical group and 65.5% in the non-surgical group (P=0.027); 5-year OS rate was 85.7% and 59.6%, respectively (P=0.008). About 22.1% of patients had metastases of less than three in the surgical group, while the rate was 42.9% in the non-surgical group (P=0.011). Patients with metastases of less than three had longer PFS than those with three or more, with a 3-year PFS rate of 72.8% and 65.8%, respectively (P=0.019). But their difference in 5-year OS rate was not significant (91.7% vs 55.3%, P=0.08). CONCLUSION: Followed by continuous TKI therapy, R0 surgery significantly prolongs the survival of patients with GLM, regardless of the extent of disease or the phase of metastasis.
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spelling pubmed-62571092018-12-11 Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center Xiao, Binyi Peng, Jianhong Tang, Jinghua Zhang, Rongxin Li, Cong Lin, Junzhong Ding, Peirong Wan, Desen Pan, Zhizhong Wu, Xiaojun Cancer Manag Res Original Research OBJECTIVES: Gastrointestinal stromal tumor (GIST) liver metastasis (GLM) is a special subset of advanced GIST, because its lesions are easier to define and assess. We aim to determine the role of liver metastasectomy for patients with GLM in the era of tyrosine kinase inhibitor (TKI) therapy. METHODS: We reviewed patients with metastatic GIST who received surgery or other treatments in Sun Yat-sen University Cancer Center between January 1991 and December 2017. Patients with metastases confined to the liver and with no previous metastasis to other locations were included into the study and were classified into surgical and non-surgical groups. All patients received 400 mg/d imatinib after the operation. We compared progression-free survival (PFS) and overall survival (OS) between the two groups. RESULTS: A total of 102 patients were included into the study. Of them, 21 (20.1%) underwent surgery for liver metastases and 81 (79.9%) received TKI therapy alone. During the operation, six patients received radiofrequency ablation for suspicious or unresectable lesions. Three-year PFS rate was 77.5% in the surgical group and 65.5% in the non-surgical group (P=0.027); 5-year OS rate was 85.7% and 59.6%, respectively (P=0.008). About 22.1% of patients had metastases of less than three in the surgical group, while the rate was 42.9% in the non-surgical group (P=0.011). Patients with metastases of less than three had longer PFS than those with three or more, with a 3-year PFS rate of 72.8% and 65.8%, respectively (P=0.019). But their difference in 5-year OS rate was not significant (91.7% vs 55.3%, P=0.08). CONCLUSION: Followed by continuous TKI therapy, R0 surgery significantly prolongs the survival of patients with GLM, regardless of the extent of disease or the phase of metastasis. Dove Medical Press 2018-11-22 /pmc/articles/PMC6257109/ /pubmed/30538560 http://dx.doi.org/10.2147/CMAR.S187061 Text en © 2018 Xiao et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Xiao, Binyi
Peng, Jianhong
Tang, Jinghua
Zhang, Rongxin
Li, Cong
Lin, Junzhong
Ding, Peirong
Wan, Desen
Pan, Zhizhong
Wu, Xiaojun
Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title_full Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title_fullStr Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title_full_unstemmed Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title_short Liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
title_sort liver surgery prolongs the survival of patients with gastrointestinal stromal tumor liver metastasis: a retrospective study from a single center
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257109/
https://www.ncbi.nlm.nih.gov/pubmed/30538560
http://dx.doi.org/10.2147/CMAR.S187061
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