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Role of Surgery in Patients with Recurrent, Metastatic, or Unresectable Locally Advanced Gastrointestinal Stromal Tumors Sensitive to Imatinib: A Retrospective Analysis of the Spanish Group for Research on Sarcoma (GEIS)

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

Abstract

Background

Recurrent, metastatic, and locally advanced gastrointestinal stromal tumors (GISTs) can be treated successfully with imatinib mesylate. Surgery for residual disease has been suggested for nonrefractory metastatic GISTs to reduce the probability of resistant recurrent clones, although no randomized Phase III trial has been performed to answer the question about its benefit. We carried out an analysis of the outcome of patients with recurrent unresectable locally advanced or metastatic imatinib-sensitive priamary GIST in 14 institutions in Spain. We compared two cohorts: treated or not treated with surgery after partial response or stabilization by imatinib.

Patients and Methods

Data were obtained from the online GIST registry of the Spanish Group for Research in Sarcomas. Selected patients were then divided into two groups: group A, treated initially only with imatinib, and group B, treated additionally with metastasectomy. Baseline characteristics between groups were compared, and univariate and multivariate analysis for progression-free survival and overall survival (OS) were performed.

Results

Analysis was undertaken in 171 patients considered nonrefractory to imatinib. The median follow-up time was 56.6 months. Focusing on OS, the Eastern Cooperative Oncology Group performance status different than 0, extent of disease limited to one metastatic organ, and comparison between groups A or B achieved statistical difference in the multivariate analysis. Median survival was 59.9 months in group A and 87.6 months in group B.

Conclusions

Based in its benefit in OS, our study supports surgery of metastatic disease in GIST patients who respond to imatinib therapy.

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Authors and Affiliations

  1. Department of Medical Oncology, Institut Català d’Oncologia de Girona, Hospital Josep Trueta, Girona, Spain

    Jordi Rubió-Casadevall MD

  2. Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain

    Javier Martinez-Trufero MD

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Xabier Garcia-Albeniz MD

  4. Molecular Oncology Laboratory, Fundación de Investigación del Hospital General Universitario de Valencia, Valencia, Spain

    Silvia Calabuig MD

  5. Department of Medical Oncology, Hospital Universitario Sant Pau, Barcelona, Spain

    Antonio Lopez-Pousa MD

  6. Department of Medical Oncology, Institut Català d’Oncologia L’Hospitalet, Barcelona, Spain

    Javier Garcia del Muro MD

  7. Department of Medical Oncology, Hospital Universitario Río Hortega, Valladolid, Spain

    Joaquin Fra MD

  8. Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain

    Andrés Redondo MD

  9. Department of Medical Oncology, Hospital de Navarra, Navarra, Spain

    Nuria Lainez MD

  10. Department of Medical Oncology, Fundación Instituto Valenciano de Oncología, Valencia, Spain

    Andrés Poveda MD

  11. Department of Medical Oncology, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    Claudia Valverde MD

  12. Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain

    Ana De Juan MD

  13. Department of Medical Oncology, Hospital Universitario Virgen de la Victoria y Regional de Málaga, Málaga, Spain

    Isabel Sevilla MD

  14. Department of Medical Oncology, Hospital Clinico San Carlos, Madrid, Spain

    Antonio Casado MD

  15. Department of Medical Oncology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

    Raquel Andres MD

  16. Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain

    Josefina Cruz MD

  17. Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain

    Javier Martin-Broto MD

  18. Department of Medical Oncology, Hospital Clinic, CIBERehd, IDIBAPS, Barcelona, Spain

    Joan Maurel MD

Authors
  1. Jordi Rubió-Casadevall MD
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  2. Javier Martinez-Trufero MD
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  3. Xabier Garcia-Albeniz MD
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  4. Silvia Calabuig MD
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  5. Antonio Lopez-Pousa MD
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  6. Javier Garcia del Muro MD
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  7. Joaquin Fra MD
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  8. Andrés Redondo MD
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  9. Nuria Lainez MD
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  10. Andrés Poveda MD
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  11. Claudia Valverde MD
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  12. Ana De Juan MD
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  13. Isabel Sevilla MD
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  14. Antonio Casado MD
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  15. Raquel Andres MD
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  16. Josefina Cruz MD
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  17. Javier Martin-Broto MD
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  18. Joan Maurel MD
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the Spanish Group for Research on Sarcoma (GEIS)

Corresponding author

Correspondence to Jordi Rubió-Casadevall MD.

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Rubió-Casadevall, J., Martinez-Trufero, J., Garcia-Albeniz, X. et al. Role of Surgery in Patients with Recurrent, Metastatic, or Unresectable Locally Advanced Gastrointestinal Stromal Tumors Sensitive to Imatinib: A Retrospective Analysis of the Spanish Group for Research on Sarcoma (GEIS). Ann Surg Oncol 22, 2948–2957 (2015). https://doi.org/10.1245/s10434-014-4360-8

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  • DOI: https://doi.org/10.1245/s10434-014-4360-8

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