Lei Cheng, Wang Qi-san, Wang Hai-jiang, Yin Dong, Liu Lin, Jin Bo
Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Mar;16(3):251-5.
To investigate the clinical characteristics and prognosis factors of primary resectable high-risk gastrointestinal stromal tumors (GIST).
The clinicopathological and follow-up data of 45 patients with primary resectable high-risk gastrointestinal stromal tumors between January 2002 and November 2010 were retrospectively reviewed.
Forty-five patients included 18 males and 27 females with a median age of 48 years (range, 28-77 years). Of 45 tumors, 19 (42.2%) located in the stomach, 9 (20.0%) in the small intestine, 7 (15.6%) in the rectum, 4 (8.9%) in the mesentery, and 6 (13.3%) in the retroperitoneum. All the patients received surgical resection and 35 (77.8%) underwent complete resection, 10 (22.2%) underwent resection of ruptured tumors (before or during operation), 33 (73.3%) underwent R0 resection, 5 (11.1%) underwent R1 resection, and 7 (15.6%) underwent R2 resection. All the patients received targeted therapy of imatinib after surgery. The median duration of imatinib was 24 (10-99) months. The main side effect was noticed in all the patients, mainly including edema in 39 (86.7%) patients and leukopenia in 27 (60.0%) patients. The relapse rate was 37.8% (17/45). The 1-, 3-, and 5-year survival rates were 100%, 86.7% and 74.4%, respectively. Univariate and multivariate analysis revealed that the degree of resection was independently associated with the prognosis of high-risk GIST patients.
Surgery is effective treatment for the GIST. Efforts to obtain R0 resection are important to improve the efficacy of primary resectable high-risk GIST.
探讨原发性可切除高危胃肠道间质瘤（GIST）的临床特征及预后因素。
回顾性分析2002年1月至2010年11月期间45例原发性可切除高危胃肠道间质瘤患者的临床病理及随访资料。
45例患者中，男性18例，女性27例，中位年龄48岁（范围28 - 77岁）。45个肿瘤中，19个（42.2%）位于胃，9个（20.0%）位于小肠，7个（15.6%）位于直肠，4个（8.9%）位于肠系膜，6个（13.3%）位于腹膜后。所有患者均接受了手术切除，35例（77.8%）行根治性切除，10例（22.2%）行破裂肿瘤切除（术前或术中），33例（73.3%）行R0切除，5例（11.1%）行R1切除，7例（15.6%）行R2切除。所有患者术后均接受伊马替尼靶向治疗。伊马替尼的中位治疗时间为24（10 - 99）个月。所有患者均出现主要副作用，主要包括39例（86.7%）患者出现水肿，27例（60.0%）患者出现白细胞减少。复发率为37.8%（17/45）。1年、3年和5年生存率分别为100%、86.7%和74.4%。单因素和多因素分析显示，切除程度与高危GIST患者的预后独立相关。
手术是治疗GIST的有效方法。努力实现R0切除对于提高原发性可切除高危GIST的疗效很重要。
