Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, PR China.
Surg Today. 2010 Oct;40(10):936-42. doi: 10.1007/s00595-009-4171-x. Epub 2010 Sep 25.
To evaluate the effectiveness of resecting liver metastases of gastrointestinal stromal tumors (GISTs), when performed in conjunction with imatinib treatment.
Forty-one patients with pathologically diagnosed GIST and liver metastases were randomly assigned to an operation group (neoadjuvant therapy + resection + adjuvant therapy with imatinib) or a nonoperation group (imatinib alone). Patients were monitored for up to 36 months, and survival was analyzed.
We monitored 39 patients throughout the 36-month follow-up period, recording 1- and 3-year survival rates of 100% and 89.5% in the operation group and 85% and 60% in the nonoperation group, respectively. There was a significant difference in overall survival between the operation and nonoperation groups (P = 0.03). Furthermore, resection improved the survival of patients who responded poorly to 6 months of preoperative imatinib treatment, compared with that of their counterparts in the nonoperation group (P = 0.04).
These findings suggest that surgical intervention in combination with imatinib treatment is more effective than imatinib alone against GIST liver metastases, with minimal complications and side effects.
评估胃肠间质瘤（GIST）肝转移灶切除联合伊马替尼治疗的有效性。
将 41 例经病理诊断为 GIST 且伴有肝转移的患者随机分为手术组（新辅助治疗+切除+伊马替尼辅助治疗）和非手术组（单纯伊马替尼治疗）。对患者进行最长 36 个月的随访，分析生存情况。
我们对 39 例患者进行了 36 个月的随访，手术组的 1 年和 3 年生存率分别为 100%和 89.5%，而非手术组分别为 85%和 60%。手术组与非手术组的总生存率差异有统计学意义（P = 0.03）。此外，与非手术组相比，对术前伊马替尼治疗 6 个月反应不佳的患者进行切除，可改善其生存情况（P = 0.04）。
这些发现表明，与单纯伊马替尼治疗相比，手术干预联合伊马替尼治疗对 GIST 肝转移更有效，且并发症和副作用较小。
