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Surgical and Oncological Outcomes after Neoadjuvant Therapy for Non-Metastatic Gastric GISTs

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Abstract

Surgical resection with negative margins of non-metastatic gastric GISTs is considered the main therapeutic option in GISTs treatment. Neoadjuvant therapy with imatinib is associated with higher response rates in advanced GISTs. We reported 34 patients with non-metastatic gastric GISTs who underwent partial gastrectomy at the Oncology Center, Mansoura University, Egypt, after receiving a daily dose of 400 mg of imatinib as a neoadjuvant treatment in the period between October 2012 and January 2021. Twenty-two cases underwent open partial gastrectomy, and twelve cases had a laparoscopic partial gastrectomy. The median tumor size at diagnosis was 13.5 cm (range 9–26 cm) and the duration of neoadjuvant therapy was 10.91 months (range 4–12 months). Thirty-three patients had a partial response, while one patient showed progression of the disease on neoadjuvant treatment. Adjuvant therapy was conducted in 29 (85.3%) cases. Complications of neoadjuvant treatment were reported in seven cases in the form of gastritis, bleeding per rectum, fatigue, thrombocytopenia, neutropenia, and edema lower limbs. The disease-free survival (DFS) in this study was 34.53 months, and the overall survival (OS) was 37 months. Recurrence developed in two cases, gastric and peritoneal recurrence (25 and 48 months from the initial diagnosis, respectively). We have concluded that neoadjuvant treatment with imatinib for non-metastatic gastric GISTs is a safe and effective method for tumor downsizing and devitalization to allow minimally invasive and/or organ sparing surgery. Moreover, it decreases the risk of intraoperative tumor rupture and relapse, thus improving the oncological outcome of such tumors.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available and are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are grateful to their patients and colleagues at the Oncology Center, Mansoura University.

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Authors and Affiliations

  1. Department of Surgical Oncology, Oncology Center, Mansoura University (OCMU), Gihan St., 35516, Mansoura, Egypt

    Amr Abouzid, Ahmed Setit & Mosab Shetiwy

  2. Medical Oncology Unit, Department of Internal Medicine, Oncology Center, Mansoura University (OCMU), Gihan St., 35516, Mansoura, Egypt

    Ziad Emarah

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  1. Amr Abouzid
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  2. Ahmed Setit
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  4. Mosab Shetiwy
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Amr Abouzid. The first draft of the manuscript was written by Amr Abouzid and all authors commented on previous versions of the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Amr Abouzid.

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Ethics Approval and Consent to Participate

Approval was obtained from the Institutional Research Board (IRB) of the Faculty of Medicine, Mansoura University, code R.21.02.1229. Written informed consent was obtained from all the patients included in this study.

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Not applicable.

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The authors declare no competing interests.

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Abouzid, A., Setit, A., Emarah, Z. et al. Surgical and Oncological Outcomes after Neoadjuvant Therapy for Non-Metastatic Gastric GISTs. Indian J Surg Oncol 14, 21–27 (2023). https://doi.org/10.1007/s13193-022-01611-w

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  • DOI: https://doi.org/10.1007/s13193-022-01611-w

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