title: Comparison of the long-term risk of recurrence and other clinical outcomes in GIST patients receiving imatinib as adjuvant therapy--a retrospective chart extract-based approach.
abstract: OBJECTIVE
  To compare characteristics of patients, the risk of recurrence, and mortality among adult patients with primary resectable gastrointestinal stromal tumor (GIST) receiving short-term (6-12 months) versus long-term (≥ 24 months) imatinib therapy.
  
  
  METHODS
  Detailed information on primary resectable KIT-positive GIST patients initiated on imatinib adjuvant therapy was retrospectively collected for short- and long-term imatinib patients from 318 US oncologists using an online data collection form. Patient characteristics were compared using Wilcoxon and Chi-square tests. Disease recurrence and mortality rates were compared using multivariate Cox proportional hazard models.
  
  
  RESULTS
  Among the 406 short-term and 406 long-term imatinib patients, the median follow-up was 916 and 970 days, respectively. While patients generally had similar demographic characteristics, the short-term group had a higher prevalence of cardiovascular and ischemic heart diseases and patients in the long-term group had a higher pre-surgery risk profile. This finding was consistent with the main reason reported by oncologists for prescribing adjuvant imatinib over longer duration, i.e., patient risk profile. Disease recurrence [5.9 versus 1.2 %, (p < .001)] and mortality rates [7.1 % versus 2.0 %, (p < .001)] were higher in short- versus long-term patients. The adjusted risk of recurrence was 5.30 times (p < .001) higher, and mortality risk was 4.02 times (p < .001) higher in short- versus long-term patients.
  
  
  CONCLUSIONS
  Patient risk profile is an important factor in oncologists' decisions to prescribe adjuvant imatinib. Despite the higher risk profile observed in long-term patients, the long-term use of imatinib was associated with a reduction in long-term risk of disease recurrence and mortality.
authors.affiliation: Department of Sarcoma, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, USA.
authors.forename: Anthony Paul
authors.initials: AP
authors.lastname: Conley
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.forename: Medha
authors.initials: M
authors.lastname: Sasane
authors.forename: Geneviève
authors.initials: G
authors.lastname: Gauthier
authors.forename: Frances
authors.initials: F
authors.lastname: Schwiep
authors.forename: Christopher Hunt
authors.initials: CH
authors.lastname: Keir
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001549:Benzamides / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D010879:Piperazines / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians'; D011743:Pyrimidines / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D013995:Time; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate