Prognosis analysis of patients with intermediate and high risk gastrointestinal stromal tumor after surgery

doi:10.3877/cma.j.issn.1674-3946.2021.04.030

Abstract

Abstract:

Objective

In order to provide individualized therapeutic treatment for patients with gastrointestinal stromal tumor (GIST), we explored the timing of targeted therapy for gastrointestinal stromal tumor (GIST) with Imatinib mesylate (IM).

Methods

The clinicopathological and follow-up data of 482 GIST patients treated in our center from 2011 to 2017 were analyzed retrospectively, and all the data were analyzed by using SPSS 22.0 software. Propensity score matching was applied to all cases, then we analyzed the clinical data by using χ² test, multivariate logistic regression, and Kaplan-Meier method, which was used for analyzing postoperative survival. The value of propensity score matching calipers was set as 0.02, and a P value of < 0.05 was considered as statistically significant difference.

Results

The 5-year relapse-free survival (RFS) of 71.8% vs. 53.8% (P=0.026) and 5-year overall survival (OS) of 76.0% vs. 54.7% (P=0.045) of patients with medium to high risk of GIST were significantly better in patients who received IM treatment than the untreated patients. With increased therapuetic time with IM, 3/5-year OS of the patients were increased with improved prognosis (OS, P=0.006, RFS, P=0.004).

Conclusion

Targeted therapy after surgery could improve the prognosis of patients with medium to high-risk of GIST , and the increased IM treatment time could further improve the clinical outcome.

Key words: Gastrointestinal stromal tumor, Imatinib mesylate, Targeted therapy, Risk, Prognosis

Feng Wang, Heng Yu, Meng Wang, Wenxian Guan. Prognosis analysis of patients with intermediate and high risk gastrointestinal stromal tumor after surgery[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 460-463.

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Figures/Tables 4

References 20

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临床特征		未治疗组(n＝74)	治疗组(n＝74)	P值
年龄(岁)
	≤60	36	41	0.411
	>60	38	33	0.411
性别
	男性	37	33	0.510
	女性	37	41	0.510
肿瘤原发部位
	胃	47	51	0.487
	非胃	27	23	0.487
肿瘤直径(cm)
	≤5	14	14	0.473
	5～10	45	51
	>10	15	9
Ki-67指数(%)
	≤5	44	50	0.419
	6～10	21	14
	>10	9	10
危险度分级
	中	28	29	0.866
	高	46	45	0.866
核分裂数(个/50HPF)
	≤5	37	39	0.750
	5～10	17	8
	>10	20	27
基因分型
	C-kit 9	4	2	0.635
	C-kit 11	60	63
	PDGFRA 12	3	1
	PDGFRA 18	3	6
	野生型	4	2

临床特征		未治疗组(n＝74)	治疗组(n＝74)	P值
年龄(岁)
	≤60	36	41	0.411
	>60	38	33	0.411
性别
	男性	37	33	0.510
	女性	37	41	0.510
肿瘤原发部位
	胃	47	51	0.487
	非胃	27	23	0.487
肿瘤直径(cm)
	≤5	14	14	0.473
	5～10	45	51
	>10	15	9
Ki-67指数(%)
	≤5	44	50	0.419
	6～10	21	14
	>10	9	10
危险度分级
	中	28	29	0.866
	高	46	45	0.866
核分裂数(个/50HPF)
	≤5	37	39	0.750
	5～10	17	8
	>10	20	27
基因分型
	C-kit 9	4	2	0.635
	C-kit 11	60	63
	PDGFRA 12	3	1
	PDGFRA 18	3	6
	野生型	4	2

治疗时间	例	3年OS	5年OS	3年RFS	5年RFS
≤12月	39	78.60	60.20	73.40	57.40
12～36月	72	89.20	57.90	77.70	61.60
>36月	35	100	90.00	100	94.10
P值			0.006		0.004

治疗时间	例	3年OS	5年OS	3年RFS	5年RFS
≤12月	39	78.60	60.20	73.40	57.40
12～36月	72	89.20	57.90	77.70	61.60
>36月	35	100	90.00	100	94.10
P值			0.006		0.004

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