Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib - Analysis of prognostic factors (EORTC-STBSG collaborative study)

S. Bauer, P. Rutkowski, P. Hohenberger, R. Miceli, E. Fumagalli, J. A. Siedlecki, B. P. Nguyen, M. Kerst, M. Fiore, P. Nyckowski, M. Hoiczyk, A. Cats, P. G. Casali, J. Treckmann, F. Van Coevorden, A. Gronchi

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Background Long-term complete remissions remain a rare exception in patients with metastatic gastrointestinal stromal tumors (GIST) treated with IM (imatinib). To date the therapeutic relevance of surgical resection of metastatic disease remains unknown except for the use in palliative intent. Patients and methods We analyzed overall survival (OS) and progression-free survival (PFS) in consecutive patients with metastatic GIST who underwent metastasectomy and received IM therapy (n = 239). Results Complete resection (R0+R1) was achieved in 177 patients. Median OS was 8.7 y for R0/R1 and 5.3 y in pts with R2 resection (p = 0.0001). In the group who were in remission at time of resection median OS was not reached in the R0/R1 surgery and 5.1 y in the R2-surgery (p = 0.0001). Median time to relapse/progression after resection of residual disease was not reached in the R0/R1 and 1.9 years in the R2 group of patients, who were resected in response. No difference in mPFS was seen in patients progressing at time of surgery. Conclusions: Our analysis implicates possible long-term survival in patients in whom surgical complete remission can be achieved. Incomplete resection, including debulking surgery does not seem to prolong survival. Despite the retrospective character and likely selection bias, this analysis may help in decision making for surgical approaches in metastatic GIST.

Original languageEnglish
Pages (from-to)412-419
Number of pages8
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number4
DOIs
Publication statusPublished - 2014

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Metastasectomy
Gastrointestinal Stromal Tumors
Survival
Selection Bias
Imatinib Mesylate
Disease-Free Survival
Decision Making
Recurrence
Therapeutics

Keywords

  • Gastrointestinal stromal tumor
  • Imatinib
  • Metastatic disease
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib - Analysis of prognostic factors (EORTC-STBSG collaborative study). / Bauer, S.; Rutkowski, P.; Hohenberger, P.; Miceli, R.; Fumagalli, E.; Siedlecki, J. A.; Nguyen, B. P.; Kerst, M.; Fiore, M.; Nyckowski, P.; Hoiczyk, M.; Cats, A.; Casali, P. G.; Treckmann, J.; Van Coevorden, F.; Gronchi, A.

In: European Journal of Surgical Oncology, Vol. 40, No. 4, 2014, p. 412-419.

Research output: Contribution to journalArticle

Bauer, S. ; Rutkowski, P. ; Hohenberger, P. ; Miceli, R. ; Fumagalli, E. ; Siedlecki, J. A. ; Nguyen, B. P. ; Kerst, M. ; Fiore, M. ; Nyckowski, P. ; Hoiczyk, M. ; Cats, A. ; Casali, P. G. ; Treckmann, J. ; Van Coevorden, F. ; Gronchi, A. / Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib - Analysis of prognostic factors (EORTC-STBSG collaborative study). In: European Journal of Surgical Oncology. 2014 ; Vol. 40, No. 4. pp. 412-419.
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abstract = "Background Long-term complete remissions remain a rare exception in patients with metastatic gastrointestinal stromal tumors (GIST) treated with IM (imatinib). To date the therapeutic relevance of surgical resection of metastatic disease remains unknown except for the use in palliative intent. Patients and methods We analyzed overall survival (OS) and progression-free survival (PFS) in consecutive patients with metastatic GIST who underwent metastasectomy and received IM therapy (n = 239). Results Complete resection (R0+R1) was achieved in 177 patients. Median OS was 8.7 y for R0/R1 and 5.3 y in pts with R2 resection (p = 0.0001). In the group who were in remission at time of resection median OS was not reached in the R0/R1 surgery and 5.1 y in the R2-surgery (p = 0.0001). Median time to relapse/progression after resection of residual disease was not reached in the R0/R1 and 1.9 years in the R2 group of patients, who were resected in response. No difference in mPFS was seen in patients progressing at time of surgery. Conclusions: Our analysis implicates possible long-term survival in patients in whom surgical complete remission can be achieved. Incomplete resection, including debulking surgery does not seem to prolong survival. Despite the retrospective character and likely selection bias, this analysis may help in decision making for surgical approaches in metastatic GIST.",
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T1 - Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib - Analysis of prognostic factors (EORTC-STBSG collaborative study)

AU - Bauer, S.

AU - Rutkowski, P.

AU - Hohenberger, P.

AU - Miceli, R.

AU - Fumagalli, E.

AU - Siedlecki, J. A.

AU - Nguyen, B. P.

AU - Kerst, M.

AU - Fiore, M.

AU - Nyckowski, P.

AU - Hoiczyk, M.

AU - Cats, A.

AU - Casali, P. G.

AU - Treckmann, J.

AU - Van Coevorden, F.

AU - Gronchi, A.

PY - 2014

Y1 - 2014

N2 - Background Long-term complete remissions remain a rare exception in patients with metastatic gastrointestinal stromal tumors (GIST) treated with IM (imatinib). To date the therapeutic relevance of surgical resection of metastatic disease remains unknown except for the use in palliative intent. Patients and methods We analyzed overall survival (OS) and progression-free survival (PFS) in consecutive patients with metastatic GIST who underwent metastasectomy and received IM therapy (n = 239). Results Complete resection (R0+R1) was achieved in 177 patients. Median OS was 8.7 y for R0/R1 and 5.3 y in pts with R2 resection (p = 0.0001). In the group who were in remission at time of resection median OS was not reached in the R0/R1 surgery and 5.1 y in the R2-surgery (p = 0.0001). Median time to relapse/progression after resection of residual disease was not reached in the R0/R1 and 1.9 years in the R2 group of patients, who were resected in response. No difference in mPFS was seen in patients progressing at time of surgery. Conclusions: Our analysis implicates possible long-term survival in patients in whom surgical complete remission can be achieved. Incomplete resection, including debulking surgery does not seem to prolong survival. Despite the retrospective character and likely selection bias, this analysis may help in decision making for surgical approaches in metastatic GIST.

AB - Background Long-term complete remissions remain a rare exception in patients with metastatic gastrointestinal stromal tumors (GIST) treated with IM (imatinib). To date the therapeutic relevance of surgical resection of metastatic disease remains unknown except for the use in palliative intent. Patients and methods We analyzed overall survival (OS) and progression-free survival (PFS) in consecutive patients with metastatic GIST who underwent metastasectomy and received IM therapy (n = 239). Results Complete resection (R0+R1) was achieved in 177 patients. Median OS was 8.7 y for R0/R1 and 5.3 y in pts with R2 resection (p = 0.0001). In the group who were in remission at time of resection median OS was not reached in the R0/R1 surgery and 5.1 y in the R2-surgery (p = 0.0001). Median time to relapse/progression after resection of residual disease was not reached in the R0/R1 and 1.9 years in the R2 group of patients, who were resected in response. No difference in mPFS was seen in patients progressing at time of surgery. Conclusions: Our analysis implicates possible long-term survival in patients in whom surgical complete remission can be achieved. Incomplete resection, including debulking surgery does not seem to prolong survival. Despite the retrospective character and likely selection bias, this analysis may help in decision making for surgical approaches in metastatic GIST.

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KW - Imatinib

KW - Metastatic disease

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KW - Survival

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