The benefit of surgery during systematic therapy for gastrointestinal stromal tumor liver metastasis: a SEER-based retrospective study.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Report Pub Date : 2024-11-25 eCollection Date: 2024-01-01 DOI:10.1093/gastro/goae095

Bozhi Hu, Yingjiang Ye, Zhidong Gao

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引用次数: 0

Abstract

Background: The liver is the most common site of gastrointestinal stromal tumor (GIST) metastasis. Most patients who develop metastases gradually develop multiline drug resistance during long-term systematic treatment. We aimed to evaluate the benefit of surgery during the systematic treatment of GIST liver metastases.

Methods: Data on GISTs with liver metastasis were retrieved from the Surveillance, Epidemiology, and End Results database. This study included 607 patients, of whom 380 patients were treated with chemotherapy alone (Chemo group) and 227 patients underwent surgery in addition to chemotherapy (Chemo&Surg group). The primary outcomes were cancer-specific survival (CSS) and overall survival (OS). Propensity score matching (PSM) was performed to balance the baseline factors.

Results: According to the multivariate analysis, surgery benefitted both CSS and OS (P < 0.001). After PSM, surgical resection still showed significant benefits in terms of both CSS and OS (P < 0.001). Surgery combined with chemotherapy increased the median CSS by at least 63 months and the median OS by at least 76 months. Subgroup analysis of the Chemo&Surg group revealed that the timing of surgery was not an independent influencing factor for either CSS or OS.

Conclusions: We found that performing additional surgery, in addition to systematic therapy, for GIST liver metastasis resulted in improved CSS and OS. These benefits were not affected by the timing of surgery during systemic treatment.

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胃肠道间质瘤肝转移系统治疗期间手术的益处：一项基于SEER的回顾性研究。

背景：肝脏是胃肠道间质瘤（GIST）最常见的转移部位：肝脏是胃肠道间质瘤（GIST）最常见的转移部位。大多数发生转移的患者在长期系统治疗过程中会逐渐产生多线耐药性。我们旨在评估手术在系统治疗 GIST 肝转移过程中的益处：方法：我们从监测、流行病学和最终结果数据库中检索了GIST肝转移的数据。这项研究包括607名患者，其中380名患者只接受了化疗（化疗组），227名患者在化疗的基础上接受了手术（化疗&手术组）。主要结果是癌症特异性生存率（CSS）和总生存率（OS）。为平衡基线因素，进行了倾向评分匹配（PSM）：结果：多变量分析显示，手术对 CSS 和 OS 均有益处（P 0.001）。PSM 后，手术切除在 CSS 和 OS 方面仍有显著优势（P 0.001）。手术联合化疗可使中位 CSS 延长至少 63 个月，中位 OS 延长至少 76 个月。对化疗&手术组进行的分组分析显示，手术时机并不是CSS或OS的独立影响因素：我们发现，在系统治疗的基础上对 GIST 肝转移灶进行额外手术可改善 CSS 和 OS。这些益处不受系统治疗期间手术时机的影响。

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

Gastroenterology Report Medicine-Gastroenterology

CiteScore

4.60

自引率

2.80%

发文量

审稿时长

8 weeks

期刊介绍： Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.