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The Effects of Surgical Cytoreduction Prior to Imatinib Therapy on the Prognosis of Patients with Advanced GIST

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Baseline tumor size is one of important prognostic factors for imatinib therapy in patients with advanced gastrointestinal stromal tumor (GIST). The purpose of this study was to determine whether surgical cytoreduction before imatinib therapy can improve the prognosis.

Methods

A total of 249 patients with advanced GIST were reviewed retrospectively. Patients were categorized into two groups according to the degree of initial cytoreduction: 35 patients with ≥75 % of initial tumor bulk removed (cytoreduction group) and the other 214 patients (no cytoreduction group). The median follow-up was 44.0 months.

Results

Patients in the cytoreduction group were younger, in better performance, showed more initially metastatic disease, peritoneal metastases, but fewer liver metastases. The baseline tumor size when starting imatinib became significantly reduced in the cytoreduction group, which made significant difference between the two groups. By multivariate analyses, mutational status, tumor size, and granulocyte count at presentation were associated with progression-free survival. Age and tumor size were associated with overall survival. However, initial cytoreduction was not significantly related to the prognosis.

Conclusions

Cytoreduction before imatinib therapy appears not to improve the prognosis. Imatinib therapy should still represent the initial treatment for advanced GIST.

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Disclosure

Yoon-Koo Kang received honoraria for the lecture, compensation for the consultation and research grant from Novartis. None of the other authors of this study have any financial disclosures.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Ho Jung An MD, Min-Hee Ryu MD, PhD, Baek-Yeol Ryoo MD, PhD, Byeong Seok Sohn MD, PhD & Yoon-Koo Kang MD, PhD

  2. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Ki-Hun Kim MD, PhD, Sung Tae Oh MD, PhD, Chang Sik Yu MD, PhD, Jeong Hwan Yook MD, PhD & Byung Sik Kim MD, PhD

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  1. Ho Jung An MD
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  2. Min-Hee Ryu MD, PhD
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  3. Baek-Yeol Ryoo MD, PhD
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  4. Byeong Seok Sohn MD, PhD
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  5. Ki-Hun Kim MD, PhD
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  6. Sung Tae Oh MD, PhD
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  7. Chang Sik Yu MD, PhD
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  8. Jeong Hwan Yook MD, PhD
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  9. Byung Sik Kim MD, PhD
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  10. Yoon-Koo Kang MD, PhD
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Corresponding author

Correspondence to Yoon-Koo Kang MD, PhD.

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An, H.J., Ryu, MH., Ryoo, BY. et al. The Effects of Surgical Cytoreduction Prior to Imatinib Therapy on the Prognosis of Patients with Advanced GIST. Ann Surg Oncol 20, 4212–4218 (2013). https://doi.org/10.1245/s10434-013-3279-9

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  • DOI: https://doi.org/10.1245/s10434-013-3279-9

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