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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2013

01-12-2013 | Gastrointestinal Oncology

The Effects of Surgical Cytoreduction Prior to Imatinib Therapy on the Prognosis of Patients with Advanced GIST

Authors: Ho Jung An, MD, Min-Hee Ryu, MD, PhD, Baek-Yeol Ryoo, MD, PhD, Byeong Seok Sohn, MD, PhD, Ki-Hun Kim, MD, PhD, Sung Tae Oh, MD, PhD, Chang Sik Yu, MD, PhD, Jeong Hwan Yook, MD, PhD, Byung Sik Kim, MD, PhD, Yoon-Koo Kang, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2013

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Abstract

Background

Baseline tumor size is one of important prognostic factors for imatinib therapy in patients with advanced gastrointestinal stromal tumor (GIST). The purpose of this study was to determine whether surgical cytoreduction before imatinib therapy can improve the prognosis.

Methods

A total of 249 patients with advanced GIST were reviewed retrospectively. Patients were categorized into two groups according to the degree of initial cytoreduction: 35 patients with ≥75 % of initial tumor bulk removed (cytoreduction group) and the other 214 patients (no cytoreduction group). The median follow-up was 44.0 months.

Results

Patients in the cytoreduction group were younger, in better performance, showed more initially metastatic disease, peritoneal metastases, but fewer liver metastases. The baseline tumor size when starting imatinib became significantly reduced in the cytoreduction group, which made significant difference between the two groups. By multivariate analyses, mutational status, tumor size, and granulocyte count at presentation were associated with progression-free survival. Age and tumor size were associated with overall survival. However, initial cytoreduction was not significantly related to the prognosis.

Conclusions

Cytoreduction before imatinib therapy appears not to improve the prognosis. Imatinib therapy should still represent the initial treatment for advanced GIST.
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Metadata
Title
The Effects of Surgical Cytoreduction Prior to Imatinib Therapy on the Prognosis of Patients with Advanced GIST
Authors
Ho Jung An, MD
Min-Hee Ryu, MD, PhD
Baek-Yeol Ryoo, MD, PhD
Byeong Seok Sohn, MD, PhD
Ki-Hun Kim, MD, PhD
Sung Tae Oh, MD, PhD
Chang Sik Yu, MD, PhD
Jeong Hwan Yook, MD, PhD
Byung Sik Kim, MD, PhD
Yoon-Koo Kang, MD, PhD
Publication date
01-12-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3279-9

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