Abstract
Purpose
To investigate the outcomes of a combined treatment regimen comprising primary surgery and tyrosine kinase inhibitor (TKI) therapy for synchronous metastatic gastrointestinal stromal tumors (GIST).
Methods
We analyzed retrospectively 14 cases of synchronous metastatic GIST from the Kinki GIST registry between 2003 and 2007.
Results
The primary tumor was located in the stomach, small intestine, and rectum in seven, six, and one patients, respectively. Metastatic tumors developed in the liver, peritoneum, other sites, and multiple organs in three, six, two, and three patients, respectively. The R0 resection rate was 42.9 % and the 5-year overall survival rate was 69.3 %. There was no significant difference in the 5-year overall survival rate between patients who underwent R0/R1 and those who underwent R2 resection (71.4 vs. 68.6 %). There was a strong correlation between survival time from diagnosis and the duration of imatinib therapy (Pearson’s correlation coefficient, 0.86; p < 0.001).
Conclusions
Although the role of surgery in the treatment of synchronous metastatic GIST is still unclear, primary surgery as the sole frontline treatment may not have a survival benefit: Continuous TKI therapy is more important for prolonging survival.
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Acknowledgments
This study was performed by the Kinki GIST Study Group, which includes the following institutions: Osaka University Hospital, Osaka General Medical Center, Shizuoka General Hospital, Osaka National Hospital, Osaka Red Cross Hospital, Toyonaka Municipal Hospital, Tenri Hospital, Osaka City General Hospital, Osaka City University Hospital, Osaka Police Hospital, Sakai Municipal Hospital, Kanazawa Medical University Hospital, Kitano Hospital, Juntendo University Shizuoka Hospital, Osaka Rosai Hospital, Osaka Medical College Hospital, Matsushita Memorial Hospital, Kyoto City Hospital, Shiga Medical Center for Adults, Hyogo Cancer Center, Hoshigaoka Koseinenkin Hospital, Kinki University Hospital, Kansai Electric Power Hospital, National Hospital Organization Osaka Minami Medical Center, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Yodogawa Christian Hospital, Osaka Medical Center for Cancer and Cardiovascular Diseases, Kansai Medical University Takii Hospital, Sumitomo Hospital, Suita Municipal Hospital, The Hospital of Hyogo College of Medicine, Osaka City Sumiyoshi Hospital, Kansai Medical University Hirakata Hospital, Nissei Hospital, Otemae Hospital, Bell Land General Hospital, Minoh City Hospital, Osaka Ekisaikai Hospital, Higashiosaka City General Hospital, and Rinku General Medical Center.
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Toshirou Nishida received funding for clinical research from Novartis and Bayer. The other authors declare no conflicts of interest.
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Sato, S., Tsujinaka, T., Yamamoto, K. et al. Primary surgery as a frontline treatment for synchronous metastatic gastrointestinal stromal tumors: an analysis of the Kinki GIST registry. Surg Today 46, 1068–1075 (2016). https://doi.org/10.1007/s00595-015-1282-4
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DOI: https://doi.org/10.1007/s00595-015-1282-4