Small-sized gastrointestinal stromal tumors: Is there an association between expectant management and overall survival? Journal Article

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Authors: Patel, DJ; Bunn, C; Kulshrestha, S; Tonelli, C; Littau, M; Kim, P; Luchette, F; Abdelsattar, Z; Baker, MS
Article Title: Small-sized gastrointestinal stromal tumors: Is there an association between expectant management and overall survival?
Abstract: BACKGROUND: Small-sized gastrointestinal stromal tumors (GISTs) have limited malignant potential. Few studies evaluate the safety and efficacy of expectant management (EM) for patients presenting with small GIST. METHODS: We queried the National Cancer Database to identify patients =65 years presenting with GISTs smaller than 3 cm in size between 2004 and 2015. Patients undergoing EM were 1:3 propensity score matched for relevant covariates to patients undergoing resection. Kaplan-Meier (KM) analysis of matched cohorts was used to evaluate the association between EM and overall survival (OS). RESULTS: 1330 patients met inclusion criteria; 966 (72.6%) had gastric GISTs. 1196 (89.9%) underwent resection; 134 (10.1%) EM. 117 patients undergoing EM were propensity-matched to 356 patients undergoing resection. There was no difference in 5-year OS between patients undergoing EM and those undergoing resection (95.7% vs 92.6%, p = 0.4882). CONCLUSIONS: Survival for small GISTs is similar with expectant management or resection.
Journal Title: American Journal of Surgery
ISSN: 1879-1883; 0002-9610
Publisher: Elsevier Inc  
Date Published: 2021