Adjuvant systemic therapy for intermediate and large gastric gastrointestinal stromal tumors (GISTs): Is there a survival benefit following margin negative surgical resection? Journal Article

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Authors: Patel, DJ; Lutfi, W; Sweigert, P; Eguia, E; Abood, G; Knab, L; Kuo, PC; Baker, MS
Article Title: Adjuvant systemic therapy for intermediate and large gastric gastrointestinal stromal tumors (GISTs): Is there a survival benefit following margin negative surgical resection?
Abstract: BACKGROUND: The value of adjuvant systemic therapy after margin-negative resection for gastric gastrointestinal stromal tumors (GISTs) remains unclear. METHODS: The National Cancer Data Base was queried to identify patients undergoing margin negative resections for gastric GISTs >2?cm between 2010 and 2015. Patients were stratified by tumor size (small: 2.1-5?cm, intermediate: 5.1-10?cm, large: >10?cm), histologic grade (low: =5 mitoses/50 HPF and high: >5 mitoses/50 HPF), and use of adjuvant therapy. Multivariable cox proportional hazard methods were used to compare overall survival (OS). RESULTS: 3520 patients met inclusion criteria. Adjuvant therapy was associated with a statistical improvement in OS (86% vs. 76%, p?=?0.014) for those with large tumors but had no measurable effect in patients with small or intermediate sized tumors. On multivariable analysis, this association was independent of grade. CONCLUSIONS: Adjuvant therapy is associated with improved OS for patients with gastric GISTs >10?cm but provides no statistically significant benefit in OS for those with GISTs 2-10?cm.
Journal Title: American Journal of Surgery
ISSN: 1879-1883; 0002-9610
Publisher: Elsevier Inc  
Date Published: 2019