Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis

被引:6
|
作者
Ling, Jia-Yu [1 ,2 ]
Ding, Miao-Miao [1 ,2 ]
Yang, Zi-Feng [2 ,3 ]
Zhao, Yan-Dong [2 ,4 ]
Xie, Xiao-Yu [1 ,2 ]
Shi, Li-Shuo [2 ,5 ]
Wang, Huai-Ming [2 ,3 ]
Cao, Wu-Teng [2 ,6 ]
Zhang, Jian-Wei [1 ,2 ]
Hu, Hua-Bin [1 ,2 ]
Cai, Yue [1 ,2 ]
Wang, Hui [2 ,3 ]
Deng, Yan-Hong [1 ,2 ]
机构
[1] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Med Oncol, 26 Yuancun Erheng Rd, Guangzhou 510655, Peoples R China
[2] Guangdong Prov Key Lab Colorectal & Pelv Floor Di, Guangzhou, Peoples R China
[3] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Colorectal Surg, Guangzhou, Peoples R China
[4] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Pathol, Guangzhou, Peoples R China
[5] Sun Yat Sen Univ, Affiliated Hosp 6, Ctr Clin Res, Guangzhou, Peoples R China
[6] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Radiol, Guangzhou, Peoples R China
关键词
imatinib; inverse probability of treatment weighting (IPTW); neoadjuvant; rectal GIST; GASTROINTESTINAL STROMAL TUMORS; ERA; GUIDELINES; MANAGEMENT; RECURRENCE; MUTATIONS; DIAGNOSIS; PROGNOSIS; SURVIVAL; EFFICACY;
D O I
10.1002/jso.26664
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and Objectives This study aimed to compare outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal gastrointestinal stromal tumors (GIST) patients. Methods Eighty-five patients with localized rectal GIST were divided into two groups: upfront surgery +/- adjuvant imatinib (Group A, n = 33) and the neoadjuvant imatinib + surgery + adjuvant imatinib (Group B, n = 52). Baseline characteristics between groups were controlled for with inverse probability of treatment weighting (IPTW) adjusted analysis. Results The response rate to neoadjuvant imatinib was 65.9%. After the IPTW-adjusted analysis, patients who underwent neoadjuvant therapy had better distant recurrence-free survival (DRFS) and disease-specific survival (DSS) compared with those who underwent upfront surgery (5-year DRFS 97.8 vs. 71.9%, hazard ratio [HR], 0.15; 95% CI, 0.03-0.87; p = 0.03; 5-year DSS 100 vs. 77.1%; HR, 0.11; 95% CI, 0.01-0.92; p = 0.04). While no significant association was found between overall survival (OS) and treatment groups (p = 0.07), 5-year OS was higher for the neoadjuvant group than upfront surgery group (97.8% vs. 71.9%; HR, 0.2; 95% CI, 0.03-1.15). Conclusions In patients with localized rectal GIST, neoadjuvant imatinib not only shrunk the tumor size but also decreased the risk of metastasis and tumor-related deaths when compared to upfront surgery and adjuvant imatinib alone.
引用
收藏
页码:1442 / 1450
页数:9
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