Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study

Peter Hohenberger, Sylvie Bonvalot, Frits van Coevorden, Pjotr Rutkowski, Eberhard Stoeckle, Christine Olungu, Saskia Litiere, Eva Wardelmann, Alessandro Gronchi, Paolo Casali

Research output: Contribution to journalArticle

Abstract

Background: EORTC (European Organisation of Research and Treatment of Cancer) 62024 is a phase III randomised trial evaluating adjuvant imatinib in patients with gastrointestinal stromal tumours (GISTs) and no evidence of residual disease after surgery in 908 patients from 11 countries participated. As surgical treatment aspects (tumour rupture and incomplete resection) contribute to the risk of recurrence, the data of primary surgery were reviewed. Methods: The surgical record, local pathology report and a surgical questionnaire on details of the operation had to be completed when patients entered the study. Surgeons from 5 countries, covering 8 languages, reviewed the full set of data being available from 793 patients (87.3%). Results: A known GIST was the reason for surgery in only 58% of the cases, and 12% of the patients were treated as an emergency. The R0-resection rate was 87%. The extent of resection was local excision in 17%, segmental resection in 59%, full-organ resection in 11% and multivisceral resection in 11%, with lymphadenectomy performed in 24% of the patients. Shelling out of the tumour was performed in 9.7%, and the proportion of tumours removed in parts was higher in the endoscopy/laparoscopy group. The incidence of tumour rupture (representing M1) was 9%. The consistency between preoperative and intraoperative findings was 82%. The postoperative complication rate was 7.3%. Conclusion: The standardisation of surgery in this study was inferior. Given the review data, 18% of the patients should not have participated in the trial. Quality of surgery and improperly reported intraoperative details might influence the trial results. A detailed surgical questionnaire filled out by the surgeon is mandatory before entering the patient in an adjuvant trial in GIST.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalEuropean Journal of Cancer
Volume120
DOIs
Publication statusPublished - Oct 2019

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Gastrointestinal Stromal Tumors
Research
Neoplasms
Therapeutics
Rupture
Imatinib Mesylate
Lymph Node Excision
Laparoscopy
Endoscopy
Emergencies
Language
Pathology
Recurrence
Incidence

Keywords

  • Adjuvant treatment
  • Gastro-intestinal stromal tumor
  • Imatinib
  • Quality assessment
  • Surgical oncology trials
  • Surgical reporting
  • Surgical treatment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study. / Hohenberger, Peter; Bonvalot, Sylvie; van Coevorden, Frits; Rutkowski, Pjotr; Stoeckle, Eberhard; Olungu, Christine; Litiere, Saskia; Wardelmann, Eva; Gronchi, Alessandro; Casali, Paolo.

In: European Journal of Cancer, Vol. 120, 10.2019, p. 47-53.

Research output: Contribution to journalArticle

Hohenberger, Peter ; Bonvalot, Sylvie ; van Coevorden, Frits ; Rutkowski, Pjotr ; Stoeckle, Eberhard ; Olungu, Christine ; Litiere, Saskia ; Wardelmann, Eva ; Gronchi, Alessandro ; Casali, Paolo. / Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study. In: European Journal of Cancer. 2019 ; Vol. 120. pp. 47-53.
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title = "Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study",
abstract = "Background: EORTC (European Organisation of Research and Treatment of Cancer) 62024 is a phase III randomised trial evaluating adjuvant imatinib in patients with gastrointestinal stromal tumours (GISTs) and no evidence of residual disease after surgery in 908 patients from 11 countries participated. As surgical treatment aspects (tumour rupture and incomplete resection) contribute to the risk of recurrence, the data of primary surgery were reviewed. Methods: The surgical record, local pathology report and a surgical questionnaire on details of the operation had to be completed when patients entered the study. Surgeons from 5 countries, covering 8 languages, reviewed the full set of data being available from 793 patients (87.3{\%}). Results: A known GIST was the reason for surgery in only 58{\%} of the cases, and 12{\%} of the patients were treated as an emergency. The R0-resection rate was 87{\%}. The extent of resection was local excision in 17{\%}, segmental resection in 59{\%}, full-organ resection in 11{\%} and multivisceral resection in 11{\%}, with lymphadenectomy performed in 24{\%} of the patients. Shelling out of the tumour was performed in 9.7{\%}, and the proportion of tumours removed in parts was higher in the endoscopy/laparoscopy group. The incidence of tumour rupture (representing M1) was 9{\%}. The consistency between preoperative and intraoperative findings was 82{\%}. The postoperative complication rate was 7.3{\%}. Conclusion: The standardisation of surgery in this study was inferior. Given the review data, 18{\%} of the patients should not have participated in the trial. Quality of surgery and improperly reported intraoperative details might influence the trial results. A detailed surgical questionnaire filled out by the surgeon is mandatory before entering the patient in an adjuvant trial in GIST.",
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author = "Peter Hohenberger and Sylvie Bonvalot and {van Coevorden}, Frits and Pjotr Rutkowski and Eberhard Stoeckle and Christine Olungu and Saskia Litiere and Eva Wardelmann and Alessandro Gronchi and Paolo Casali",
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T1 - Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study

AU - Hohenberger, Peter

AU - Bonvalot, Sylvie

AU - van Coevorden, Frits

AU - Rutkowski, Pjotr

AU - Stoeckle, Eberhard

AU - Olungu, Christine

AU - Litiere, Saskia

AU - Wardelmann, Eva

AU - Gronchi, Alessandro

AU - Casali, Paolo

PY - 2019/10

Y1 - 2019/10

N2 - Background: EORTC (European Organisation of Research and Treatment of Cancer) 62024 is a phase III randomised trial evaluating adjuvant imatinib in patients with gastrointestinal stromal tumours (GISTs) and no evidence of residual disease after surgery in 908 patients from 11 countries participated. As surgical treatment aspects (tumour rupture and incomplete resection) contribute to the risk of recurrence, the data of primary surgery were reviewed. Methods: The surgical record, local pathology report and a surgical questionnaire on details of the operation had to be completed when patients entered the study. Surgeons from 5 countries, covering 8 languages, reviewed the full set of data being available from 793 patients (87.3%). Results: A known GIST was the reason for surgery in only 58% of the cases, and 12% of the patients were treated as an emergency. The R0-resection rate was 87%. The extent of resection was local excision in 17%, segmental resection in 59%, full-organ resection in 11% and multivisceral resection in 11%, with lymphadenectomy performed in 24% of the patients. Shelling out of the tumour was performed in 9.7%, and the proportion of tumours removed in parts was higher in the endoscopy/laparoscopy group. The incidence of tumour rupture (representing M1) was 9%. The consistency between preoperative and intraoperative findings was 82%. The postoperative complication rate was 7.3%. Conclusion: The standardisation of surgery in this study was inferior. Given the review data, 18% of the patients should not have participated in the trial. Quality of surgery and improperly reported intraoperative details might influence the trial results. A detailed surgical questionnaire filled out by the surgeon is mandatory before entering the patient in an adjuvant trial in GIST.

AB - Background: EORTC (European Organisation of Research and Treatment of Cancer) 62024 is a phase III randomised trial evaluating adjuvant imatinib in patients with gastrointestinal stromal tumours (GISTs) and no evidence of residual disease after surgery in 908 patients from 11 countries participated. As surgical treatment aspects (tumour rupture and incomplete resection) contribute to the risk of recurrence, the data of primary surgery were reviewed. Methods: The surgical record, local pathology report and a surgical questionnaire on details of the operation had to be completed when patients entered the study. Surgeons from 5 countries, covering 8 languages, reviewed the full set of data being available from 793 patients (87.3%). Results: A known GIST was the reason for surgery in only 58% of the cases, and 12% of the patients were treated as an emergency. The R0-resection rate was 87%. The extent of resection was local excision in 17%, segmental resection in 59%, full-organ resection in 11% and multivisceral resection in 11%, with lymphadenectomy performed in 24% of the patients. Shelling out of the tumour was performed in 9.7%, and the proportion of tumours removed in parts was higher in the endoscopy/laparoscopy group. The incidence of tumour rupture (representing M1) was 9%. The consistency between preoperative and intraoperative findings was 82%. The postoperative complication rate was 7.3%. Conclusion: The standardisation of surgery in this study was inferior. Given the review data, 18% of the patients should not have participated in the trial. Quality of surgery and improperly reported intraoperative details might influence the trial results. A detailed surgical questionnaire filled out by the surgeon is mandatory before entering the patient in an adjuvant trial in GIST.

KW - Adjuvant treatment

KW - Gastro-intestinal stromal tumor

KW - Imatinib

KW - Quality assessment

KW - Surgical oncology trials

KW - Surgical reporting

KW - Surgical treatment

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