title: Role of surgery in patients with focally progressive gastrointestinal stromal tumors resistant to imatinib.
abstract: The benefits of surgery for focally progressive gastrointestinal stromal tumor (GIST) during imatinib therapy are still in discussion. The aim of this study was to compare the outcomes of surgical resection of progressive lesions following tyrosine kinase inhibitor (TKI) therapy (S group) or TKI therapy alone (NS group) in GIST patients. We retrospectively investigated 57 patients with focally progressive GIST during imatinib therapy who were treated in Zhongshan hospital, Fudan University. Progression-free survival (PFS) and overall survival (OS) in the S group were significantly longer than those in the NS group. Among S group, the patients with R0 resection showed longer PFS than R2 resection; however, no difference was found between these two groups. Moreover, PFS and OS were not different in the NS-S group compared with S group. On multivariate analysis, surgery is an independent prognostic factor for longer PFS and OS. Our study supports the decision of treating GIST patients who were focally resistant to imatinib with surgery resection based on its benefit.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Anwei
authors.initials: A
authors.lastname: Xue
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Shu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Jiaqian
authors.initials: J
authors.lastname: Ling
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
authors.forename: Yingyong
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Kuntang
authors.initials: K
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.|Institute of General Surgery, Fudan University, Shanghai, 200032, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Qin
mesh_terms: D000328:Adult; D000368:Aged; D019008:Drug Resistance, Neoplasm; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D000068877:Imatinib Mesylate