Li Chen, Lu Yunwei, Zhang Meng-Meng, Wu Hao, Li Han, Ye Ying-Jiang, Jiang Kewei
Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, China.
Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Surg. 2022 Oct 21;9:968585. doi: 10.3389/fsurg.2022.968585. eCollection 2022.
Colonic gastrointestinal stromal tumor (cGIST) and rectal gastrointestinal stromal tumor (rGIST) are two rare subtypes of gastrointestinal stromal tumor (GIST). The view that colonic and rectal carcinoma are different is generally accepted; however, whether there is a difference between cGIST and rGIST is still unknown. Here, we aimed to provide evidence for future clinical management and research by comparing the differences between the two types of GIST in the above-mentioned aspects.
Patients were enrolled from three medical centers in China and published literature was collected following the inclusion and exclusion criteria. Propensity score matching was used to eliminate differences between cohorts.
Between cGIST and rGIST patients, significant differences were observed in age, tumor size, mitotic index, NIH risk category, growth pattern, and symptoms. Adjuvant therapy is used in a high proportion of cGIST patients, and neoadjuvant therapy is used in a high proportion of rGIST patients. Although local resection is the main surgical method in both cohorts, the proportion is higher in cGIST patients. The overall survival of rGIST patients was better than that of the cGIST patients before propensity score matching (PSM). Interestingly, no significant differences in prognosis were observed after PSM.
Although there were significant differences between cGIST and rGIST patients in baseline characteristics, clinicopathological features, treatment choice, and overall survival rate before PSM, no significant differences in long-term survival were observed between the two groups after PSM. In our study, there may be no differences in the tumor entity between cGIST and rGIST.
结肠胃肠道间质瘤（cGIST）和直肠胃肠道间质瘤（rGIST）是胃肠道间质瘤（GIST）的两种罕见亚型。结肠癌和直肠癌存在差异这一观点已被普遍接受；然而，cGIST和rGIST之间是否存在差异仍不清楚。在此，我们旨在通过比较这两种类型GIST在上述方面的差异，为未来的临床管理和研究提供证据。
从中国的三个医疗中心招募患者，并根据纳入和排除标准收集已发表的文献。采用倾向评分匹配法消除队列之间的差异。
在cGIST和rGIST患者之间，观察到年龄、肿瘤大小、有丝分裂指数、美国国立卫生研究院（NIH）风险分类、生长模式和症状方面存在显著差异。cGIST患者中辅助治疗的使用比例较高，rGIST患者中新辅助治疗的使用比例较高。虽然局部切除是两个队列中的主要手术方法，但在cGIST患者中的比例更高。在倾向评分匹配（PSM）之前，rGIST患者的总生存率优于cGIST患者。有趣的是，PSM后未观察到预后的显著差异。
虽然在PSM之前，cGIST和rGIST患者在基线特征、临床病理特征、治疗选择和总生存率方面存在显著差异，但PSM后两组之间未观察到长期生存的显著差异。在我们的研究中，cGIST和rGIST之间的肿瘤实体可能没有差异。
