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Treatment options for giant gastrointestinal stromal tumours and related prognosis: a single‐centre retrospective study
Author(s) -
Wang Feng,
Tao Tingting,
Wang Xingzhou,
Yu Heng,
Xia Xuefeng,
Wang Meng,
Guan Wenxian,
Shi Xiaolei
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15785
Subject(s) - medicine , gist , retrospective cohort study , imatinib , surgery , resection , stromal cell , overall survival , surgical resection , myeloid leukemia
Background Controversy persists about the best treatment for giant gastrointestinal stromal tumours (GISTs). This retrospective study aimed to investigate the different treatments for giant GISTs and the effect on outcomes. Methods A total of 71 patients with GIST ≥10 cm in diameter were separated into four groups according to treatment received: emergency surgery group ( n = 17), preoperative targeted (imatinib) therapy group ( n = 12), palliative resection group ( n = 17) and R0 resection group ( n = 25). Baseline, intraoperative and post‐operative findings were compared between the groups. Long‐term follow‐up was conducted to assess outcomes. Results Preoperative gastrointestinal bleeding was significantly higher ( P = 0.003) and haemoglobin level was significantly lower ( P < 0.05) in the emergency surgery group than in the other groups. Mean tumour diameter was significantly more in the palliative resection group than in the other groups ( P = 0.023). Overall survival was significantly higher in the R0 resection group and the preoperative targeted therapy group than in the other two groups ( P < 0.05). Conclusion In patients with giant GISTs, the best outcomes appear to be achieved with preoperative imatinib therapy plus surgery or R0 resection followed by imatinib therapy.