Endoscopic therapy versus surgical resection for rectal gastrointestinal stromal tumors: a population-based comparative analysis of long-term survival outcomes.

Abstract

Background: Rectal gastrointestinal stromal tumors (GISTs) are relatively rare, and the long-term survival outcomes of endoscopic therapy (ET) versus surgical resection (SR) remain uncertain. This study aims to assess the long-term survival in patients with rectal GISTs treated with either ET or SR.

Methods: Patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was implemented to reduce selection bias in the comparative analyses. The impact of demographic and clinical features on overall survival (OS) and cancer-specific survival (CSS) was evaluated through Kaplan-Meier analyses and the use of multivariate Cox proportional hazards models.

Results: A total of 239 patients were included, with 146 undergoing ET and 93 undergoing SR. After PSM, 164 patients were evenly matched for comparison. There was no significant distinction between ET and SR regarding long-term OS (P = 0.592) and CSS (P = 0.832). Furthermore, subgroup analysis considering factors like age, tumor size, year of diagnosis, and sex also found no variance in OS and CSS outcomes between the groups. The multivariate Cox analysis identified advanced age as the sole independent risk factor impacting the prognosis of patients with rectal GISTs.

Conclusions: Our findings suggest that ET and SR offer comparable long-term survival outcomes for patients with rectal GISTs, indicating that ET could be considered a viable treatment option.