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Surgical Outcomes of Patients with Gastrointestinal Stromal Tumors in the Era of Targeted Drug Therapy

  • 2008 ssat poster presentation
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The discovery of the c-KIT mutation and the advent of targeted drug therapy with imatinib mesylate have revolutionized the management of gastrointestinal stromal tumors (GISTs). The outcome of patients with surgically treated GISTs treated in the era of targeted drug therapy was assessed and factors associated with adverse outcomes determined.

Materials and Methods

Patients with GISTs requiring surgery at a tertiary care center from 2002 to 2007 were reviewed and prognostic factors determined.

Results

Forty patients were surgically treated for GISTs. The median age at presentation was 59 years. The stomach (55%) was the main site of primary disease. The median tumor size was 7 cm. Eleven (28%) patients had metastatic disease at presentation. Surgery was undertaken in all patients with curative intent. Multi-organ resection was required in 10 (25%) patients. Imatinib mesylate was administered postoperatively in 68% of cases. Median follow-up was 24 months. There was a 40% recurrence rate with 63% undergoing repeat surgical resection. The peritoneum and liver were the main sites of recurrent disease. The 5-year disease-specific survival and disease-free survival (DFS) were 65% and 35%, respectively. High mitotic rate (P = 0.017) and tumor size greater than 10 cm (P = 0.009) were the only prognostically significant adverse factors of DFS on multivariate analysis, independent of imatinib mesylate treatment.

Conclusion

Aggressive surgical treatment and follow-up of GISTs, combined with targeted drug therapy, leads to long-term DFS survival. Tumor recurrence is independently associated with a high tumor mitotic rate and size greater than 10 cm, despite the use of adjuvant targeted drug therapy.

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Authors and Affiliations

  1. Department of Surgery, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, H070, 500 University Drive, P.O. Box 850, Hershey, PA, 17033-0850, USA

    Mehrdad Nikfarjam, Eric Kimchi, Serene Shereef, Niraj J. Gusani, Mandeep Sehmbey & Kevin F. Staveley-O’Carroll

  2. Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    Yixing Jiang

  3. Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    John Liang

Authors
  1. Mehrdad Nikfarjam
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  2. Eric Kimchi
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  8. Kevin F. Staveley-O’Carroll
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Correspondence to Kevin F. Staveley-O’Carroll.

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Nikfarjam, M., Kimchi, E., Shereef, S. et al. Surgical Outcomes of Patients with Gastrointestinal Stromal Tumors in the Era of Targeted Drug Therapy. J Gastrointest Surg 12, 2023–2031 (2008). https://doi.org/10.1007/s11605-008-0561-4

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  • DOI: https://doi.org/10.1007/s11605-008-0561-4

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