A long-term follow-up of the imatinib mesylate treatment for the patients with recurrent gastrointestinal stromal tumor (GIST): the liver metastasis and the outcome.
BACKGROUND
About 80% of patients with GIST would experience tumor recurrence or metastasis after radical resection. The most common site of the metastasis is the liver. Imatinib mesylate has been proved effective for advanced GIST. The present study was designed to further observe the effectiveness of the imatinib mesylate treatment on the recurrent GIST and the correlation between the liver metastasis and the outcome.


METHODS
Forty-two patients who had recurrent GIST after the first radical resection were enrolled. According to the recurrent sites, the patients were divided into 3 groups: group LG (recurrent liver GISTs), group AG (recurrent abdominal GISTs) and group ALG (recurrent abdominal and liver GISTs). All the patients were given imatinib mesylate at an initial dose of 400 mg per day. Their clinical data was prospectively collected. A follow-up over 3 years was conducted. Tumor response, time to progression and survival were evaluated.


RESULTS
The long-term imatinib mesylate treatment was safe and well tolerated. At a median follow-up time for 39.5 months, the 3-year survival rate was 66.7%. Median TTP and OS were 37 months (95% CI: 28.2 approximately 45.8 months) and 48 months (95% CI: 37.0 approximately 58.9 months), respectively. There was no statistical difference in tumor response among the 3 groups. The similar TTP (P = 0.291) and OS (P = 0.160) were observed in the 3 groups.


CONCLUSIONS
The imatinib mesylate treatment could prolong the survival of the patients who have recurrent GIST after the radical surgery in spite of an existence of the liver metastasis. Survival was not significantly affected by liver metastasis when imatinib mesylate was warranted.
Zhu
Jiang
J
Department of Thoracic Oncology, Cancer Center, West China hospital, Sichuan University, Chengdu, 610041, China.
Yang
Yu
Y
Zhou
Lin
L
Jiang
Ming
M
Hou
Mei
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D000068877:Imatinib Mesylate; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate
Ann Surg. 2001 Oct;234(4):540-7; discussion 547-8
11573047
Lancet. 2006 Oct 14;368(9544):1329-38
17046465
Curr Probl Surg. 1996 Oct;33(10):817-72
8885853
Yonsei Med J. 2009 Jun 30;50(3):437-40
19568608
Lancet. 2009 Mar 28;373(9669):1097-104
19303137
N Engl J Med. 2001 Apr 5;344(14):1052-6
11287975
Hum Pathol. 2002 May;33(5):466-77
12094371
Am J Pathol. 1998 May;152(5):1259-69
9588894
N Engl J Med. 2002 Aug 15;347(7):472-80
12181401
Histol Histopathol. 2000 Oct;15(4):1293-301
11005253
Science. 1998 Jan 23;279(5350):577-80
9438854
Ann Surg Oncol. 2001 Jan-Feb;8(1):50-9
11206225
J R Soc Med. 1991 Dec;84(12):714-6
1774744
Curr Treat Options Oncol. 2001 Dec;2(6):485-91
12057094
J Gastrointest Surg. 2002 Sep-Oct;6(5):682-9
12399057
Cancer. 2000 Jan 1;88(1):66-74
10618607
J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
10655437
Am J Pathol. 2002 May;160(5):1567-72
12000708
Br J Surg. 2003 Mar;90(3):332-9
12594669
Oncology. 2007;73(5-6):324-7
18497504