新辅助伊马替尼治疗后行经括约肌间切除术治疗低位直肠胃肠道间质瘤
Neoadjuvant Imatinib Therapy Followed by Intersphincteric Resection for Low Rectal Gastrointestinal Stromal Tumors.
作者信息
Kaneko Manabu, Nozawa Hiroaki, Emoto Shigenobu, Murono Koji, Sasaki Kazuhito, Otani Kensuke, Nishikawa Takeshi, Tanaka Toshiaki, Kiyomatsu Tomomichi, Hata Keisuke, Kawai Kazushige, Watanabe Toshiaki
机构信息
Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
出版信息
Anticancer Res. 2017 Sep;37(9):5155-5160. doi: 10.21873/anticanres.11936.
BACKGROUND/AIM: Intersphincteric resection (ISR) aims to preserve anal function in patients with very low rectal tumors. Here, we analyzed patients who underwent neoadjuvant imatinib therapy followed by ISR for low rectal gastrointestinal stromal tumors (GISTs).
PATIENTS AND METHODS
We retrospectively analyzed patients with low rectal GISTs who underwent neoadjuvant imatinib therapy and ISR between January 2013 and December 2015 at the University of Tokyo hospital.
RESULTS
The study included 4 men and 1 woman, with a median age of 67 years (range=45-67). All patients received 400 mg of neoadjuvant imatinib once daily for the median duration of 4 months (range=3-12). Microscopically, R0 resection was performed in 4 patients, and R1, in 1 patient. There was 1 recurrence event during the median follow-up duration of 35 months.
CONCLUSION
Neoadjuvant imatinib therapy and ISR for low rectal GISTs is a challenging, but promising, alternative to achieve complete resection margins and preserve anal function.
背景/目的：括约肌间切除术（ISR）旨在保留极低位直肠肿瘤患者的肛门功能。在此，我们分析了接受新辅助伊马替尼治疗后行ISR治疗低位直肠胃肠道间质瘤（GIST）的患者。
患者与方法
我们回顾性分析了2013年1月至2015年12月在东京大学医院接受新辅助伊马替尼治疗和ISR的低位直肠GIST患者。
结果
该研究纳入4名男性和1名女性，中位年龄为67岁（范围=45 - 67岁）。所有患者均接受每日一次400mg新辅助伊马替尼治疗，中位疗程为4个月（范围=3 - 12个月）。显微镜下，4例患者实现R0切除，1例患者为R1切除。在中位随访期35个月期间发生1例复发事件。
结论
新辅助伊马替尼治疗和ISR治疗低位直肠GIST是一种具有挑战性但有前景的替代方法，可实现完整的切除边缘并保留肛门功能。
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