一项关于食管胃肠间质瘤和平滑肌肉瘤的临床病理特征和长期生存的大型全国性对比研究。

A large national comparative study of clinicopathological features and long-term survivals between esophageal gastrointestinal stromal tumor and leiomyosarcoma.

机构信息

Surgical Oncology, Sentara Careplex Hospital, Sentara Healthcare System, Hampton, VA, USA.

Surgical Oncology Division, Department of Surgery, University of Miami, Miami, FL, USA.

出版信息

Am J Surg. 2019 Aug;218(2):323-328. doi: 10.1016/j.amjsurg.2018.10.046. Epub 2018 Nov 16.

DOI:10.1016/j.amjsurg.2018.10.046

PMID:30471808

Abstract

BACKGROUND

Esophageal gastrointestinal stromal tumors (E-GIST) and leiomyosarcoma (E-LMS) are rare tumors. Previous studies are limited to small number of patients. We sought to study these two tumors using a large national database.

METHODS

The National Cancer Data Base 2004-2014 was queried for patients with E-GIST and E-LMS. The primary outcome was overall survival (OS). Univariate and multivariable Cox regression models were used to investigate OS predictors.

RESULTS

We found 141 E-GIST and 38 E-LMS patients, with esophagectomy and systemic treatment rate of 55% and 49% for E-GIST and 50% and 26% for E-LMS. The 5-year OS of E-GIST and E-LMS were 62% and 23%, respectively, p < 0.001. In multivariable analysis, young age, tumor <10 cm, esophagectomy, and E-GIST were associated with superior OS. There was a higher median and mean OS with neoadjuvant vs. upfront surgery for E-GIST group (98 and 111 vs 79 and 80 months).

CONCLUSION

E E-GIST has superior OS compared to E-LMS. Esophagectomy is the cornerstone treatment modality. Further studies are needed to evaluate the role of neoadjuvant therapy in E-GIST patients.

摘要

背景

食管胃肠道间质瘤（E-GIST）和平滑肌肉瘤（E-LMS）是罕见的肿瘤。既往研究的病例数有限。我们旨在使用大型国家数据库研究这两种肿瘤。

方法

从 2004 年至 2014 年的国家癌症数据库中查询 E-GIST 和 E-LMS 患者。主要结果是总生存（OS）。使用单因素和多因素 Cox 回归模型来探讨 OS 的预测因素。

结果

我们发现了 141 例 E-GIST 和 38 例 E-LMS 患者，E-GIST 和 E-LMS 的手术切除率和系统治疗率分别为 55%和 49%、50%和 26%。E-GIST 和 E-LMS 的 5 年 OS 分别为 62%和 23%，p<0.001。多因素分析显示，年轻、肿瘤<10cm、手术切除和 E-GIST 与更好的 OS 相关。对于 E-GIST 组，新辅助治疗与直接手术相比，中位和平均 OS 更高（98 和 111 个月 vs. 79 和 80 个月）。