Surgical outcomes of locally advanced gastrointestinal stromal tumors after multivisceral resection: A retrospective study of 64 patients at a single institution.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Hui Qiu, Zhen Wang, Bonan Liu, Rongze Sun, Xiuyun Tian, Chunyi Hao
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引用次数: 0

Abstract

To analyze the outcome in patients who have undergone multivisceral resection (MVR) for locally advanced gastrointestinal stromal tumors (GISTs), and identify the risk factors for tumor recurrence and postoperative morbidity. Sixty-four patients who operated for locally advanced GISTs with MVR in PPeking University Cancer Hospital Sarcoma Center (PUCHSC) between 2013 and 2021 were identified. Clinicopathologic characteristics, surgical outcomes, recurrence, and 5-year recurrence-free and overall survival were evaluated. The mean age of the patients was 60 years. Mean tumor size was 11.1 cm. Complete resection was achieved in all patients. The estimated 5-year recurrence-free and overall survival were 86.6% and 90.0%, respectively. Independent factor of recurrence following surgery was mitotic count on multivariate analysis. Overall postoperative morbidity was 53.1% (n = 34). Severe morbidity was 21.9% (n = 14). The most common severe complication was clinically relevant pancreatic fistula (n = 12, 18.8%), followed by anastomotic leakage (n = 4, 6.3%) and Intraabdominal abscess (n = 4, 6.3%). Multivariate analysis showed that preoperative imatinib therapy could reduce overall morbidity. Long operation time, combined colectomy and pancreatectomy were independent risk factors for postoperative severe morbidity. Compared to partial pancreatectomy, pancreaticoduodenectomy (PD) was significantly increased the incidence of severe morbidity. In conclusion, compared to systemic therapy alone, the outcome of locally advanced GISTs after MVR was more favorable. Despite the high overall morbidity, the postoperative severe morbidity and mortality of MVR were acceptable. Preoperative imatinib therapy should be recommended whenever possible. Combined pancreatectomy and colectomy are associated with significant postoperative severe morbidities. PD should be thoroughly discussed and be subject to MDT approach before surgery.

多脏器切除术后局部晚期胃肠道间质瘤的手术效果:对一家医疗机构64名患者的回顾性研究。
目的 分析局部晚期胃肠道间质瘤(GIST)多脏器切除术(MVR)患者的预后,并确定肿瘤复发和术后发病率的风险因素。研究对象为2013年至2021年间在北京大学肿瘤医院肉瘤中心(PUCHSC)接受多脏器切除术治疗局部晚期胃肠道间质瘤的64例患者。对患者的临床病理特征、手术效果、复发率、5年无复发生存率和总生存率进行了评估。患者的平均年龄为60岁。肿瘤平均大小为 11.1 厘米。所有患者均实现了完全切除。估计5年无复发生存率和总生存率分别为86.6%和90.0%。多变量分析显示,有丝分裂计数是术后复发的独立因素。术后总发病率为53.1%(n = 34)。严重发病率为21.9%(14人)。最常见的严重并发症是临床相关的胰瘘(12例,18.8%),其次是吻合口漏(4例,6.3%)和腹腔内脓肿(4例,6.3%)。多变量分析显示,术前伊马替尼治疗可降低总发病率。手术时间长、联合结肠切除术和胰腺切除术是术后严重发病率的独立风险因素。与胰腺部分切除术相比,胰十二指肠切除术(PD)显著增加了严重发病率。总之,与单纯系统治疗相比,局部晚期 GIST 经 MVR 治疗后的预后更佳。尽管总发病率较高,但MVR的术后严重发病率和死亡率是可以接受的。应尽可能推荐术前伊马替尼治疗。联合胰腺切除术和结肠切除术与术后严重发病率相关。术前应对胰腺癌进行充分讨论,并采用多学科治疗小组(MDT)方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Intractable & rare diseases research
Intractable & rare diseases research MEDICINE, GENERAL & INTERNAL-
CiteScore
2.10
自引率
0.00%
发文量
29
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