title: [Efficacy analysis of targeted therapy combined with surgery in the treatment of recurrent and metastatic gastrointestinal stromal tumor].
abstract: OBJECTIVE
  To investigate the efficacy of targeted therapy combined with surgery in the treatment of recurrent and metastatic gastrointestinal stromal tumor(GIST).
  
  
  METHODS
  Clinicopathological and followed-up data of 318 patients with recurrent and metastatic GIST admitted in Zhongshan Hospital between January 2000 and December 2015 were analyzed retrospectively. According to different treatment methods, the patients were divided into four groups: surgery group (operation alone, 44 cases), target therapy group (imatinib alone, 108 cases), target therapy combined with surgery group (imatinib plus operation, 139 cases), other therapy group (chemotherapy, Chinese medicine and others, 27 cases). The progression-free survival (PFS) and overall survival (OS) of four groups were compared.
  
  
  RESULTS
  The baseline informations, such as age, gender, primary site, et al, were not significantly different (all P>0.05), but the recurrent and metastatic site was significantly different among 4 groups (P=0.000). The medial PFS of surgery group, target therapy group, target therapy combined with surgery was 16(95%CI: 4.9 to 27.0) months, 44 (95%CI: 30.9 to 57.1) months, 35 (95%CI: 26.5 to 43.5) months, respectively, and the latter 2 groups had significantly longer PFS than surgery group(P=0.000), while no significant difference was found between target therapy group and target combined with surgery group (P=0.251). The median OS of surgery group, target therapy group, target therapy combined with surgery, and other therapy group was 24 (95%CI: 9.0 to 39.0) months, 69(95%CI: 40.8 to 97.2) months, 92(95%CI: 78.0 to 106.0) months, 12(95%CI: 9.5 to 14.5) months. Target therapy group and target therapy combined with surgery group had significantly longer OS than surgery and other therapy groups (P=0.000), while the target therapy combined with surgery group had significantly longer OS than target therapy group(P=0.028).
  
  
  CONCLUSIONS
  Target therapy combined with surgery can prolong the survival of recurrent and metastatic GIST patients.
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Anwei
authors.initials: A
authors.lastname: Xue
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Shu
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: He
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Jiaqian
authors.initials: J
authors.lastname: Ling
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Pathology, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Yingyong
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China. shen.kuntang@zs-hospital.sh.cn.
authors.forename: Kuntang
authors.initials: K
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Zhongshan Hospital Fudan University; Institute of General Surgery of Fudan University, Shanghai 200032, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Qin
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010879:Piperazines; D011743:Pyrimidines; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate