Premium
Is nonanatomic rectal resection a valid therapeutic option for rectal gastrointestinal stromal tumors? A proposed decision algorithm
Author(s) -
Romain Benoit,
Delhorme JeanBaptiste,
Manceau Gilles,
Lefevre Jérémie H,
Tresallet Christophe,
Mariani Pascale,
Iannelli Antonio,
Rouanet Philippe,
Piessen Guillaume,
Brigand Cécile
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26215
Subject(s) - medicine , gist , confidence interval , relative risk , imatinib , retrospective cohort study , surgery , stromal cell , gastroenterology , myeloid leukemia
Background and objectives The best surgical approach to rectal gastrointestinal stromal tumors (GISTs) is still debated, and both nonanatomic rectal resection (NARR) and anatomic rectal resection (ARR) are applied. The aim of this study was to evaluate the feasibility and oncological outcomes of NARR and ARR for rectal GISTs (R‐GISTs). Methods Through a large French multicentre retrospective study, 35 patients were treated for R‐GIST between 2001 and 2013. Patients who underwent NARR and ARR were compared. Results There were 23 (65.7%) patients in group ARR and 12 (34.3%) in group NARR. Significantly more patients in the group with ARR had a neoadjuvant treatment (86%) with tyrosine kinase inhibitor (TKI) (imatinib) compared to those with NARR (25%) ( p < .01). The median preoperative tumor size was significantly different between the groups without and with neoadjuvant TKI: 30 ± 23 mm versus 64 ± 44.4 mm, respectively ( p < .001). Overall postoperative morbidity was 20% ( n = 7) (26% for ARR vs. 8% for NARR; p = .4). After a median follow‐up of 60.2 (3.2–164.3) months, the 5‐year disease‐free survival rates were 79.5% (confidence interval [CI] 95%: 54–100) for the NARR group and 68% (CI 95%: 46.4–89.7) for the ARR group ( p = .697), respectively. Conclusion The use of NARR for small R‐GIST's does not seem to impair the oncological prognosis.