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Xu E, Shi Q, Qi Z, Li B, Sun H, Ren Z, Cai S, He D, Lv Z, Chen Z, Zhong L, Xu L, Li X, Xu S, Zhou P, Zhong Y. Clinical outcomes of endoscopic resection for the treatment of intermediate- or high-risk gastric small gastrointestinal stromal tumors: a multicenter retrospective study. Surg Endosc 2024; 38:3353-3360. [PMID: 38698259 DOI: 10.1007/s00464-024-10753-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/14/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND AND AIMS Many studies of gastric gastrointestinal stromal tumors (g-GISTs) following endoscopic resection (ER) have typically focused on tumor size, with most tumors at low risk of aggressiveness after risk stratification. There have been few systematic studies on the oncologic outcomes of intermediate- or high-risk g-GISTs after ER. METHODS From January 2014 to January 2020, we retrospectively collected patients considered at intermediate- or high-risk of g-GISTs according to the modified NIH consensus classification system. The primary outcome was overall survival (OS). RESULTS Six hundred and seventy nine (679) consecutive patients were diagnosed with g-GISTs and treated by ER between January 2014 and January 2020 in three hospitals in Shanghai, China. 43 patients (20 males and 23 females) were confirmed at intermediate-or high-risk. The mean size of tumors was 2.23 ± 1.01 cm. The median follow-up period was 62.02 ± 15.34 months, with a range of 28 to 105 months. There were no recurrences or metastases, even among patients having R1 resections. The 5-year OS rate was 97.4% (42/43). CONCLUSION ER for intermediate- or high-risk gastric small GISTs is a feasible and safe method, which allows for a wait-and-see approach before determining the necessity for imatinib adjuvant or surgical treatment. This approach to g-GISTs does require that patients undergo close follow-up.
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Affiliation(s)
- Enpan Xu
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiang Shi
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhipeng Qi
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bing Li
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huihui Sun
- Tongji Hospital Affiliated to Tongji University, Shanghai Tongji Hospital, Shanghai, China
| | - Zhong Ren
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shilun Cai
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dongli He
- Shanghai Xuhui Central Hospital, Fudan University, Shanghai, China
| | - Zhengtao Lv
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhanghan Chen
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liang Zhong
- Huashan Hospital, Fudan University, Shanghai, China
| | - Leiming Xu
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
| | - Xiaobo Li
- Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Shuchang Xu
- Tongji Hospital Affiliated to Tongji University, Shanghai Tongji Hospital, Shanghai, China
| | - Pinghong Zhou
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yunshi Zhong
- Zhongshan Hospital, Fudan University, Shanghai, China.
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Jiang X, Qu A, Xu X, Kuang H, Liu L, Xu C. Ultrasensitive detection of imatinib in human serum using a gold-based paper sensor. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1234:124001. [PMID: 38281369 DOI: 10.1016/j.jchromb.2024.124001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
Imatinib is the tyrosine kinase inhibitor of choice for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. However, imatinib has drawbacks such as drug resistance and significant differences in pharmacokinetics within patients. Therefore, a colloidal gold-based immunochromatographic assay (CG-IA) was developed for measuring and monitoring imatinib in human serum. An imatinib derivative containing carboxyl groups was used for the synthesis of the immunogen, and 4-(4-methyl-1-piperazinylmethyl) benzoic acid was selected as the hapten for the heterologous coating antigen. Next, a highly sensitive and specific monoclonal antibody (mAb), 2F7 was screened for the construction of a CG-IA, with an IC50 value of 0.091 ng/mL. For the qualification of imatinib in human serum, the visual limit of detection (vLOD) and cut-off values of the CG-IA were 2 and 20 ng/mL, respectively. For quantitative detection, the calculated LOD value of the CG-IA was 0.068 ng/mL, with a linearity range of 1.004 and 23.087 ng/mL. The recovery rate of spiked serum samples was between 88.24 % and 104.75 %. In addition, the concentration of imatinib in the serum samples from 10 patients was detected by CG-IA and revealed a good correlation with those from LC-MS/MS. These results indicated that the developed gold-based paper sensor could become an effective tool for the rapid monitoring of imatinib in human serum samples.
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Affiliation(s)
- Xiaoqian Jiang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Aihua Qu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xinxin Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Hua Kuang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liqiang Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China.
| | - Chuanlai Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China; International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
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Zhaojun X, Xiaobin C, Pengfei L, Junli M, Chengwu Z, Chen L, Xiaoming M. Analysis of risk factors and prognostic factors for gastrointestinal stromal tumors with gastrointestinal hemorrhage: Based on propensity score matching method. Surgery 2023; 173:383-391. [PMID: 36424199 DOI: 10.1016/j.surg.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study aimed to analyze the relationship between risk factors and prognosis of patients with gastrointestinal stromal tumor associated with gastrointestinal bleeding. METHODS According to whether there was gastrointestinal bleeding, 246 patients with gastrointestinal stromal tumors were divided into 2 groups. The clinicopathological baseline characteristics of the 2 groups of patients were balanced by propensity score matching, and the Kaplan-Meier method was used to draw the survival curve and analyze the overall survival of the 2 groups of patients. The receiver operating characteristic curve was drawn to evaluate the accuracy of Modified National Institutes of Health criteria and Armed Forces Institute of Pathology criteria in predicting the prognosis and postoperative recurrence of patients. Logistic regression analysis of risk factors affecting gastrointestinal stromal tumor with gastrointestinal bleeding before matching. Univariate and multivariate analyses of risk factors affecting the prognosis of patients with gastrointestinal stromal tumors after matching were performed using Cox regression models. RESULTS Before matching, the accuracy of Modified National Institutes of Health criteria in predicting postoperative survival status and recurrence was higher than that of Armed Forces Institute of Pathology criteria. Modified National Institutes of Health criteria and relapse were the risk factors for gastrointestinal stromal tumor with gastrointestinal bleeding independent risk factors (P < .05). After 1:1 matching, the general clinical data of patients with gastrointestinal bleeding group and nongastrointestinal bleeding group were balanced (P > .05). The results of matched survival analysis indicated that tumor location and gastrointestinal bleeding were independent risk factors for the prognosis of patients with gastrointestinal stromal tumors (P < .05). The results of subgroup analysis according to anatomical site showed that there was no significant difference between the gastrointestinal bleeding group and the nongastrointestinal bleeding group (P > .05). Survival analysis showed that patients with gastrointestinal stromal tumors with gastrointestinal bleeding had a worse prognosis, and the results were also applicable in different tumor anatomical locations and different Modified National Institutes of Health criteria. CONCLUSION Modified National Institutes of Health criteria and relapse are independent risk factors for gastrointestinal stromal tumors with gastrointestinal bleeding; gastrointestinal bleeding is associated with poor prognosis in patients with gastrointestinal stromal tumors, and patients with gastrointestinal stromal tumors with gastrointestinal bleeding have a worse prognosis.
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Affiliation(s)
- Xu Zhaojun
- Graduate School, Qinghai University, Xining, China; Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Chen Xiaobin
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, China; Dongfang Hospital, Xiamen University, Fuzhou, China; Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Li Pengfei
- Graduate School, Qinghai University, Xining, China; Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Mi Junli
- Graduate School, Qinghai University, Xining, China; Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Zhang Chengwu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Lin Chen
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, China; Dongfang Hospital, Xiamen University, Fuzhou, China; Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China.
| | - Ma Xiaoming
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
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Prediction of recurrence-free survival and adjuvant therapy benefit in patients with gastrointestinal stromal tumors based on radiomics features. Radiol Med 2022; 127:1085-1097. [DOI: 10.1007/s11547-022-01549-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
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van de Wal D, Elie M, Le Cesne A, Fumagalli E, den Hollander D, Jones RL, Marquina G, Steeghs N, van der Graaf WTA, Husson O. Health-Related Quality of Life and Side Effects in Gastrointestinal Stromal Tumor (GIST) Patients Treated with Tyrosine Kinase Inhibitors: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14071832. [PMID: 35406604 PMCID: PMC8997462 DOI: 10.3390/cancers14071832] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The introduction of tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of gastrointestinal stromal tumors (GISTs), resulting in a substantial gain in median overall survival. Subsequently, health-related quality of life (HRQoL) has become more relevant. Here, we systematically review the available literature on HRQoL issues and side effects of different TKIs registered for the treatment of GIST. METHODS A search through five databases was performed. Full reports in English describing HRQoL outcomes and/or side effects in GIST patients on TKI therapy were included. RESULTS A total of 104 papers were included; 13 studies addressed HRQoL, and 96 studies investigated adverse events. HRQoL in patients treated with imatinib, regorafenib, and ripretinib remained stable, whereas most sunitinib-treated patients reported a decrease in HRQoL. Severe fatigue and fear of recurrence or progression were specifically assessed as HRQoL issues and had a negative impact on overall HRQoL as well as psychological and physical well-being. The majority of studies focused on physician-reported side effects. Nearly all GIST patients treated with a TKI experienced at least one adverse event, mostly mild to moderate. CONCLUSIONS Despite the fact that almost all patients treated with a TKI experienced side effects, this did not seem to affect overall HRQoL during TKI therapy. In daily practice, it are the side effects that hamper a patient's HRQoL resulting in treatment adjustments, suggesting that the reported side effects were underestimated by physicians, or the measures used to assess HRQoL do not capture all relevant issues that determine a GIST patient's HRQoL.
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Affiliation(s)
- Deborah van de Wal
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
| | - Mai Elie
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (M.E.); (D.d.H.)
| | - Axel Le Cesne
- Department of Medical Oncology, Gustave Roussy, 94805 Villejuif, France;
| | - Elena Fumagalli
- Department of Medical Oncology, IRCCS Foundation National Cancer Institute, 20133 Milan, Italy;
| | - Dide den Hollander
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (M.E.); (D.d.H.)
| | - Robin L. Jones
- Department of Clinical Oncology, The Royal Marsden Hospital and Institute of Cancer Research, London SM2 5 NG, UK;
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico San Carlos, 28040 Madrid, Spain;
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Clinical Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Winette T. A. van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Division of Clinical Studies, Institute of Cancer Research, London SM2 5NG, UK
- Correspondence: ; Tel.: +31-614-549-755
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Qu H, Xu Z, Ren Y, Gong Z, Ju RH, Zhang F, Kang H, Xu Y, Chen X. Recent Advancements in the Treatment of Rectal Gastrointestinal Stromal Tumor: In Era of Imatinib. Cancer Manag Res 2022; 14:1141-1152. [PMID: 35321404 PMCID: PMC8934706 DOI: 10.2147/cmar.s352860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/18/2022] [Indexed: 12/30/2022] Open
Abstract
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal tract, with an annual incidence of 10–15 cases per million. However, rectal GIST has a low incidence, accounting for approximately 0.1% of all rectal tumors. The treatment of rectal GISTs is still controversial and the relative unified guidelines and consensus opinions are inadequate. Treatment is based primarily on the clinical experience of the physician. The widespread application of neoadjuvant imatinib therapy allows diversification of treatment, especially in the choice of surgical methods. Herein, we reviewed the most recent literature and summarized the new progress in rectal tumor treatment, with the aim of providing patients with more systematic and individualized therapeutic strategies.
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Affiliation(s)
- Hui Qu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - ZhaoHui Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - YanYing Ren
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
| | - ZeZhong Gong
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Ri Hyok Ju
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Fan Zhang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
| | - HaoNan Kang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Yang Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Chen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Correspondence: Xin Chen, Tel +86 17709872266, Email
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Reis NRP, Barbosa LER. Prognostic Factors and Management of Colorectal Gastrointestinal Stromal Tumors. JOURNAL OF COLOPROCTOLOGY 2022. [DOI: 10.1055/s-0041-1740297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Introduction The gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Even though it can be found in any location of the digestive tract, the colorectal GIST is rare. With this study, we aim to review the current knowledge regarding the prognosis and management of colorectal GIST.
Methods A literature search was conducted in PubMed, and 717 articles were collected. After analyzing these studies, 60 articles were selected to use in this review.
Results The mitotic index, as well as tumor size and location were identified as good discriminators of prognosis in various studies. Surgery remains the only curative therapy for potentially resectable tumors. However, even after surgical resection, some patients develop disease recurrence and metastasis, especially those with high-risk tumors. Therefore, surgical resection alone might be inadequate for the management of all colorectal GISTs. The discovery of GIST's molecular pathway led to a shift in its therapy, insofar as tyrosine kinase inhibitors became part of the treatment schemes for this tumor, revolutionizing the treatment's outcome and prognosis.
Discussion/Conclusion The controversy concerning colorectal GIST prognosis and treatment can be, in part, attributed to the limited number of studies in the literature. In this review, we gathered the most recent knowledge about the prognosis and management of GIST in this rare location and propose two algorithms for its approach. Lastly, we highlight the importance of an individualized approach in the setting of a multidisciplinary team.
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Affiliation(s)
- Nuno Rafael Pereira Reis
- Department of Surgery and Physiology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Laura Elisabete Ribeiro Barbosa
- Department of Surgery and Physiology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Department of General Surgery, Centro Hospitalar Universitário São João, Serviço de Cirurgia Geral, Porto, Portugal
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Zemła P, Stelmach A, Jabłońska B, Gołka D, Mrowiec S. A Retrospective Study of Postoperative Outcomes in 98 Patients Diagnosed with Gastrointestinal Stromal Tumor (GIST) of the Upper, Middle, and Lower Gastrointestinal Tract Between 2009 and 2019 at a Single Center in Poland. Med Sci Monit 2021; 27:e932809. [PMID: 34645778 PMCID: PMC8525312 DOI: 10.12659/msm.932809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) arise in the smooth muscle pacemaker interstitial cells of Cajal, or similar cells. The aim of this retrospective study between 2009 and 2019 from a single center in Poland was to assess the selected prognostic factors (location, tumor size, mitotic index, body mass index (BMI), length of hospital stay, age, sex, and coexistent neoplasm) and to investigate postoperative outcomes in 98 patients with GIST of the upper, middle, and lower gastrointestinal tract. MATERIAL AND METHODS Between 2009 and 2019, 98 patients (50 women and 48 men) with an average age of 63.8 years (range from 38 to 90 years) were operated on for GIST in the Department of Gastrointestinal Surgery in Katowice, Poland. Based on the intraoperative and postoperative investigations, the tumor size and mitotic index were determined in each case. RESULTS A statistically significant correlation between age and mitotic index (MI) was found (p=0.02). The higher the MI, the younger the age of the patients. However, regardless of sex, younger patients had a tendency to survive longer. A >60-year-old male patient's probability of survival was around 65% after 40 months. Higher mitotic index was also associated with larger tumor size (p<0.0001). Female patients had a tendency to survive longer than males. CONCLUSIONS The findings from this small retrospective study support the importance of preoperative evaluation and frequent postoperative follow-up for patients with GIST of the gastrointestinal tract, particularly in older male patients, and patients with malignant comorbidities, which are associated with increased mortality.
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Affiliation(s)
- Patryk Zemła
- Student Scientific Society, Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
| | - Anna Stelmach
- Student Scientific Society, Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
| | - Beata Jabłońska
- Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
| | - Dariusz Gołka
- Department of Pathology, Blackpool Teaching Hospitals, Blackpool, United Kingdom
| | - Sławomir Mrowiec
- Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
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Li J, Shen L. The current status of and prospects in research regarding gastrointestinal stromal tumors in China. Cancer 2020; 126 Suppl 9:2048-2053. [PMID: 32293728 DOI: 10.1002/cncr.32684] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 12/11/2022]
Abstract
China still lacks statistical data regarding the incidence of gastrointestinal stromal tumors (GISTs). Data from 3 regions have demonstrated that the incidence of GISTs in China is similar to that in the United States. Furthermore, no significant differences between both nations with regard to epidemiological characteristics and genotyping of GISTs have been reported. Chinese physicians are demonstrating an increased interest in studies regarding GISTs. Currently, to the authors' knowledge, China publishes the most research articles regarding GIST annually worldwide. Despite the paucity of relevant research regarding the clinical practices for GISTs, a series of studies performed by Chinese physicians in the fields of recurrence risk classification, laparoscopic surgery, and adjuvant therapy have contributed to the diagnosis and treatment of GISTs. The lack of innovative drugs, slow approval of new drugs, and insufficient research funds have limited further advancements in GIST-related research in China. In recent years, increased investment in scientific research has allowed for these advancements to be made by creating conditions for Chinese physicians to conduct high-level clinical research. Chinese researchers hope to further shorten the gap between China and the rest of the world in the field of GIST research within a relatively short period. The purpose of the current review article was to present the most updated information regarding the diagnosis and treatment of GISTs in Chinese medical practice and to suggest prospective research in this field.
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Affiliation(s)
- Jian Li
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education of Beijing, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Lin Shen
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education of Beijing, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
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Shu P, Sun XF, Fang Y, Gao XD, Hou YY, Shen KT, Qin J, Sun YH, Qin XY, Xue AW, Fu M. Clinical outcomes of different therapeutic modalities for rectal gastrointestinal stromal tumor: Summary of 14-year clinical experience in a single center. Int J Surg 2020; 77:1-7. [PMID: 32173609 DOI: 10.1016/j.ijsu.2020.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/15/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The optimal treatment for gastrointestinal stromal tumor (GIST) of the rectum is controversial due to the extremely low incidence of the disease. The aim of the present study was to compare the clinical outcomes of different treatment modalities for rectal GIST by reviewing the 14-year experience in our center. METHOD Medical records of rectal GIST patients who received surgical treatment in our center between January 2004 to December 2017 were reviewed retrospectively. Overall survival (OS) and recurrence-free survival (RFS) were used as the observation endpoints. RESULTS Included in this study were 71 GIST patients, including 42 patients who underwent local excision (LE) and 29 patients who underwent segmental resection (SR). There were differences in tumor size (P = 0.001) and malignant risk grade (P = 0.007). The LE approach achieved a lower rate of R0 resection than SR (29/42 vs.27/29, P = 0.015) and shorter hospital stay (P = 0.004). Preoperative imatinib mesylate (IM) therapy improved the rate of sphincter-sparing surgery for patients with tumors in the very low segment of the rectum (P = 0.012) and offered better R0 resection margins (P = 0.027). Multivariate analysis showed that the resection margin status (P = 0.014), risk stratification (P = 0.001) and IM therapy (P = 0.042) were independent factors affecting RFS of rectal GIST patients but not the surgical modalities (LE vs. SR, P = 0.802). Multivariate analysis showed no significant impact of these variables on OS. CONCLUSION Selection of surgical modalities has no significant impact on the prognosis. Local excision is the preferred surgical modality for resectable rectal GIST by virtue of less injury and shorter hospital stay. IM therapy has proved to be associated with improved RFS for rectal GIST patients.
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Affiliation(s)
- P Shu
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X F Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y Fang
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X D Gao
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y Y Hou
- Department of Pathology, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - K T Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China.
| | - J Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y H Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X Y Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - A W Xue
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - M Fu
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
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