Loyola University Chicago Stritch School of Medicine, USA.
Department of Surgery, Loyola University Medical Center, Stritch School of Medicine, Loyola University of Chicago, USA.
Am J Surg. 2022 Mar;223(3):521-525. doi: 10.1016/j.amjsurg.2021.12.015. Epub 2021 Dec 16.
Small-sized gastrointestinal stromal tumors (GISTs) have limited malignant potential. Few studies evaluate the safety and efficacy of expectant management (EM) for patients presenting with small GIST.
We queried the National Cancer Database to identify patients ≤65 years presenting with GISTs smaller than 3 cm in size between 2004 and 2015. Patients undergoing EM were 1:3 propensity score matched for relevant covariates to patients undergoing resection. Kaplan-Meier (KM) analysis of matched cohorts was used to evaluate the association between EM and overall survival (OS).
1330 patients met inclusion criteria; 966 (72.6%) had gastric GISTs. 1196 (89.9%) underwent resection; 134 (10.1%) EM. 117 patients undergoing EM were propensity-matched to 356 patients undergoing resection. There was no difference in 5-year OS between patients undergoing EM and those undergoing resection (95.7% vs 92.6%, p = 0.4882).
Survival for small GISTs is similar with expectant management or resection.
小尺寸胃肠道间质瘤（GIST）的恶性潜能有限。很少有研究评估对小 GIST 患者进行期待治疗（EM）的安全性和疗效。
我们在 2004 年至 2015 年间从国家癌症数据库中检索了≤65 岁、肿瘤大小小于 3cm 的 GIST 患者。对接受 EM 的患者进行了 1：3 的倾向评分匹配，以匹配接受切除术的患者。对匹配队列进行 Kaplan-Meier（KM）分析，以评估 EM 与总生存期（OS）之间的关系。
1330 例患者符合纳入标准；966 例（72.6%）为胃 GIST。1196 例（89.9%）接受了切除术；134 例（10.1%）接受了 EM。117 例接受 EM 的患者与 356 例接受切除术的患者进行了倾向评分匹配。接受 EM 与接受切除术的患者 5 年 OS 无差异（95.7% vs 92.6%，p=0.4882）。
小 GIST 的生存情况与期待治疗或切除术相似。
