Survival After Resection of Gastrointestinal Stromal Tumor and Sarcoma Liver Metastases in 146 Patients
We investigated outcomes by primary tumor type in patients who underwent resection of liver metastases from gastrointestinal stromal tumors (GIST), leiomyosarcomas, and other sarcomas.
Our institutional liver database was used to identify patients who underwent resection from 1998 through 2013. Histopathological, clinical, and survival data were analyzed.
One hundred forty-six patients underwent resection of liver metastases from GIST (n = 49), leiomyosarcomas (n = 47), or other sarcomas (n = 50). The 5-year overall survival (OS) rates in patients with GIST, leiomyosarcomas, and other sarcomas were 55.3, 48.4, and 44.9 %, respectively, and the 10-year OS rates were 52.5, 9.2, and 23.0 %, respectively. The 5-year recurrence-free survival (RFS) rate was better for GIST (35.7 %; p = 0.003) than for leiomyosarcomas (3.4 %) and other sarcomas (21.4 %). Lung recurrence was more common for leiomyosarcomas (36 % of patients; p < 0.0001) than for other sarcomas (12 %) and GIST (2 %). For GIST, the findings support a benefit of imatinib regarding the 5-year RFS rate compared to resection alone (47.1 vs. 9.5 %; p = 0.013). For leiomyosarcoma, primary tumor location did not affect the 5-year RFS rate (intraabdominal 14.5 %; other location 0 %; p = 0.182).
Liver metastases from GIST, leiomyosarcomas, and other sarcomas should be assessed separately as their survival and recurrence patterns are different. This is especially important for GIST, for which imatinib is now available.
KeywordsGastrointestinal stromal tumors Leiomyosarcoma Sarcoma Surgery Neoplasm metastasis Resection Liver metastases
The authors thank Stephanie Deming for editing the manuscript and Ruth J. Haynes for secretarial assistance in the preparation and submission of the manuscript.
This research was supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant, CA016672. Dr. Brudvik is supported by the Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Norway, and was awarded the Unger-Vetlesen Medical Fund for 2014
Conflict of Interest
The authors report no conflicts of interest relevant to this article.
- 1.Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G. Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 2006; 244(4):524–35.PubMedCentralPubMedGoogle Scholar
- 7.Miettinen M, Kopczynski J, Makhlouf HR, Sarlomo-Rikala M, Gyorffy H, Burke A, Sobin LH, Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol 2003; 27(5):625–41.PubMedCrossRefGoogle Scholar
- 9.Sborov D, Chen JL. Targeted therapy in sarcomas other than GIST tumors. J Surg Oncol. 2014 Oct 20. doi: 10.1002/jso.23802.
- 20.Pawlik TM, Vauthey JN, Abdalla EK, Pollock RE, Ellis LM, Curley SA. Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg 2006; 141(6):537–43.Google Scholar
- 23.Scaife CL, Hunt KK, Patel SR, Benjamin RS, Burgess MA, Chen LL, Trent J, Raymond AK, Cormier JN, Pisters PW, Pollock RE, Feig BW. Is there a role for surgery in patients with “unresectable” cKIT+ gastrointestinal stromal tumors treated with imatinib mesylate? Am J Surg 2003; 186(6):665–9.PubMedCrossRefGoogle Scholar
- 24.Antonescu CR, Besmer P, Guo T, Arkun K, Hom G, Koryotowski B, Leversha MA, Jeffrey PD, Desantis D, Singer S, Brennan MF, Maki RG, DeMatteo RP. Acquired resistance to imatinib in gastrointestinal stromal tumor occurs through secondary gene mutation. Clin Cancer Res 2005; 11(11):4182–90.PubMedCrossRefGoogle Scholar
- 25.Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 2003; 21(23):4342–9.PubMedCrossRefGoogle Scholar