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Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Surgical resection for small (≤2 cm) gastric gastrointestinal stromal tumor
1Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No. 23, Back Road of Art Gallery, Dongcheng District, Beijing, 100010, China.
Background:
It is unclear whether surgical excision is the best course of treatment for small gastric gastrointestinal stromal tumor (GIST) ≤2 cm. The aim of this study was to evaluate the long-term survival results of surgical and non-surgical treatment for small gastric GIST.
Methods:
Between 2000 and 2021, patients with small gastric GIST were chosen from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to mitigate selection bias in the comparison process. Kaplan-Meier analysis and multivariate Cox model were used to assess the effects of demographic and clinical characteristics on overall survival (OS) and cancer-specific survival (CSS).
Results:
A total of 1229 patients with gastric GIST (≤2 cm) were included, including 1004 (81.69 %) patients who underwent operative management and 225 (18.31 %) who received non-operative management. The 5-year OS and CSS rates were compared between the two groups before PSM [5-year OS (83.51 % vs. 79.53 %, P < 0.001), 5-year CSS (96.96 % vs. 91.81 %, P = 0.017)]; after PSM [5-year OS (82.79 % vs. 80.00 %, P = 0.039), and 5-year CSS (94.88 % vs. 94.42 %, P = 0.398)]. Furthermore, after correcting for covariates, operative management was associated with a significant improvement in OS (HR = 0.62, 95 % CI 0.40-0.97, P = 0.037), while no significant effect on CSS was observed (HR = 0.85, 95 % CI 0.43-1.70, P = 0.643).
Conclusions:
Our analysis demonstrated a statistically significant association between operative management and improved OS for small gastric GIST (≤2 cm).
Insights
Surgical excision offers improved overall survival for small gastric gastrointestinal stromal tumors (GIST) ≤2 cm. This study found operative management significantly benefits patients with small GIST, though cancer-specific survival showed no significant difference.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Small gastric gastrointestinal stromal tumors (GIST) ≤2 cm present a treatment dilemma regarding surgical excision.
- Long-term survival outcomes for surgical versus non-surgical management of these tumors remain unclear.
Purpose of the Study:
- To evaluate and compare the long-term survival results of surgical and non-surgical treatment for small gastric GIST (≤2 cm).
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database for patient selection (2000-2021).
- Employed propensity score matching (PSM) to minimize selection bias.
- Applied Kaplan-Meier analysis and multivariate Cox models to assess overall survival (OS) and cancer-specific survival (CSS).
Main Results:
- Included 1229 patients: 1004 (81.69%) operative, 225 (18.31%) non-operative.
- Post-PSM, operative management showed a significant improvement in 5-year OS (82.79% vs. 80.00%, P=0.039).
- Operative management was significantly associated with improved OS (HR=0.62, P=0.037), but not CSS (HR=0.85, P=0.643).
Conclusions:
- Operative management is statistically associated with improved overall survival for patients with small gastric GIST (≤2 cm).
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