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Comparison of outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal GIST: An inverse probability of treatment weighting analysis
- Source :
- Journal of Surgical Oncology. 124:1442-1450
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Background and objectives This study aimed to compare outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal gastrointestinal stromal tumors (GIST) patients. Methods Eighty-five patients with localized rectal GIST were divided into two groups: upfront surgery ± adjuvant imatinib (Group A, n = 33) and the neoadjuvant imatinib + surgery + adjuvant imatinib (Group B, n = 52). Baseline characteristics between groups were controlled for with inverse probability of treatment weighting (IPTW) adjusted analysis. Results The response rate to neoadjuvant imatinib was 65.9%. After the IPTW-adjusted analysis, patients who underwent neoadjuvant therapy had better distant recurrence-free survival (DRFS) and disease-specific survival (DSS) compared with those who underwent upfront surgery (5-year DRFS 97.8 vs. 71.9%, hazard ratio [HR], 0.15; 95% CI, 0.03-0.87; p = 0.03; 5-year DSS 100 vs. 77.1%; HR, 0.11; 95% CI, 0.01-0.92; p = 0.04). While no significant association was found between overall survival (OS) and treatment groups (p = 0.07), 5-year OS was higher for the neoadjuvant group than upfront surgery group (97.8% vs. 71.9%; HR, 0.2; 95% CI, 0.03-1.15). Conclusions In patients with localized rectal GIST, neoadjuvant imatinib not only shrunk the tumor size but also decreased the risk of metastasis and tumor-related deaths when compared to upfront surgery and adjuvant imatinib alone.
- Subjects :
- Male
medicine.medical_specialty
Gastrointestinal Stromal Tumors
medicine.medical_treatment
Antineoplastic Agents
Group B
Metastasis
medicine
Humans
In patient
Digestive System Surgical Procedures
Neoadjuvant therapy
Aged
Gastrointestinal Neoplasms
Retrospective Studies
GiST
business.industry
Hazard ratio
Imatinib
General Medicine
Prognosis
medicine.disease
Combined Modality Therapy
Neoadjuvant Therapy
Surgery
Survival Rate
Oncology
Case-Control Studies
Imatinib Mesylate
Female
business
Adjuvant
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 10969098 and 00224790
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- Journal of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....c8591a8aa00f1884698101c949390a5b