TY - JOUR
T1 - Adjuvant systemic therapy for intermediate and large gastric gastrointestinal stromal tumors (GISTs)
T2 - Is there a survival benefit following margin negative surgical resection?
AU - Patel, Dhruv J.
AU - Lutfi, Waseem
AU - Sweigert, Patrick
AU - Eguia, Emanuel
AU - Abood, Gerard
AU - Knab, Lawrence
AU - Kuo, Paul C.
AU - Baker, Marshall S.
N1 - Publisher Copyright:
© 2019
PY - 2020/3
Y1 - 2020/3
N2 - Background: The value of adjuvant systemic therapy after margin-negative resection for gastric gastrointestinal stromal tumors (GISTs) remains unclear. Methods: The National Cancer Data Base was queried to identify patients undergoing margin negative resections for gastric GISTs >2 cm between 2010 and 2015. Patients were stratified by tumor size (small: 2.1–5 cm, intermediate: 5.1–10 cm, large: >10 cm), histologic grade (low: ≤5 mitoses/50 HPF and high: >5 mitoses/50 HPF), and use of adjuvant therapy. Multivariable cox proportional hazard methods were used to compare overall survival (OS). Results: 3520 patients met inclusion criteria. Adjuvant therapy was associated with a statistical improvement in OS (86% vs. 76%, p = 0.014) for those with large tumors but had no measurable effect in patients with small or intermediate sized tumors. On multivariable analysis, this association was independent of grade.
AB - Background: The value of adjuvant systemic therapy after margin-negative resection for gastric gastrointestinal stromal tumors (GISTs) remains unclear. Methods: The National Cancer Data Base was queried to identify patients undergoing margin negative resections for gastric GISTs >2 cm between 2010 and 2015. Patients were stratified by tumor size (small: 2.1–5 cm, intermediate: 5.1–10 cm, large: >10 cm), histologic grade (low: ≤5 mitoses/50 HPF and high: >5 mitoses/50 HPF), and use of adjuvant therapy. Multivariable cox proportional hazard methods were used to compare overall survival (OS). Results: 3520 patients met inclusion criteria. Adjuvant therapy was associated with a statistical improvement in OS (86% vs. 76%, p = 0.014) for those with large tumors but had no measurable effect in patients with small or intermediate sized tumors. On multivariable analysis, this association was independent of grade.
UR - http://www.scopus.com/inward/record.url?scp=85074162880&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074162880&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2019.10.014
DO - 10.1016/j.amjsurg.2019.10.014
M3 - Article
C2 - 31679654
AN - SCOPUS:85074162880
SN - 0002-9610
VL - 219
SP - 436
EP - 439
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -