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See Latest ArticlesPost-imatinib surgery in advanced/metastatic GIST: is it worthwhile in all patients?
Annals of Oncology, 07/29/09
Mussi C et al. - In a study to determine whether post-imatinib surgery in advanced/metastatic gastrointestinal stromal tumor (GIST) is worthwhile in all pts, it was shown that surgery for focal progressive lesions could be considered part of the second-line/third-line armamentarium in selected cases. Surgery of residual disease upon best clinical response seems associated with survival benefit vs historical controls in similar pt collectives treated with imatinib alone. Evidence from prospective randomized trials is needed to make definite recommendations.
Methods- 80 pts were analyzed who underwent surgery for metastatic GIST after imatinib therapy.
- Pts were divided into those with surgery at best clinical response (group A, n=49) and those with surgery at focal progression (group B, n=31).
- Primary endpoints were progression-free survival (PFS) and disease-specific survival (DSS).
- 2-yr postoperative PFS was 64.4% in group A and 9.7% in group B.
- In group A, median PFS was not reached; in group B, it was 8 mos.
- Median DSS from the time of imatinib onset was not reached in either group.
- 5-yr DSS was 82.9% in group A and 67.6% in group B.
- Multivariate analysis confirmed a significantly shorter PFS and DSS in group B.
- Surgical morbidity occurred in 13 pts (16.3%).
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