Department of Surgical, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
J Surg Oncol. 2013 Mar;107(4):320-3. doi: 10.1002/jso.23223. Epub 2012 Jul 17.
Five percent of gastrointestinal stromal tumors (GISTs) are primarily localized in the rectum. We analyzed the outcome of multimodality treatment for rectal GIST in a multicenter retrospective series.
All surgically treated patients with a rectal GIST were identified from four specialized centers in the Netherlands. Primary endpoints were disease-free survival (DFS) and overall survival (OS).
Thirty-two patients (22 men and 10 women) with rectal GISTs were identified. Twenty-two patients received imatinib before surgery for a median of 9 (range 2-53) months (Group 1). Ten patients received no imatinib because of small tumor size or lack of availability (Group 2). Median tumor size before treatment was 9.3 (range 6-17) cm in Group 1 and median 6 (range 4-14) cm in Group 2. A complete resection was possible in 17/22 (77%) patients in Group 1 versus 7/10 (70%) in Group 2. Median DFS was not reached in Group 1, while it was 36 months in Group 2. Median OS was not reached in both groups.
Preoperative imatinib leads to downsizing of the tumors in Group 1. However, it has not led to less extensive surgery. The DFS is longer in patients treated with pre- and post-operative imatinib, without an effect on OS.
5%的胃肠道间质瘤（GIST）主要局限于直肠。我们分析了多模式治疗直肠 GIST 的结果，这是一项多中心回顾性研究。
从荷兰的四个专业中心确定了所有接受直肠 GIST 手术治疗的患者。主要终点是无病生存率（DFS）和总生存率（OS）。
确定了 32 例直肠 GIST 患者（22 名男性和 10 名女性）。22 例患者在手术前接受了伊马替尼治疗，中位时间为 9（范围 2-53）个月（组 1）。10 例患者因肿瘤体积小或无法获得伊马替尼而未接受治疗（组 2）。组 1 治疗前的肿瘤大小中位数为 9.3（范围 6-17）cm，组 2 为 6（范围 4-14）cm。组 1 中 17/22（77%）患者可完全切除，而组 2 中 7/10（70%）患者可完全切除。组 1 未达到中位 DFS，而组 2 为 36 个月。两组均未达到中位 OS。
组 1 中的伊马替尼术前使肿瘤缩小。然而，这并没有导致手术范围缩小。接受术前和术后伊马替尼治疗的患者 DFS 较长，但对 OS 没有影响。
