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Survival Similar With Partial and Total Resection of Gastrointestinal Stromal Tumors: Presented at SSO

By Crystal Phend

SAN DIEGO, C.A. -- March 27, 2006 -- Long-term survival after partial resection of gastrointestinal stromal tumors (GIST) appears to approach that of total resection, according to a study presented here at the annual meeting of the Society of Surgical Oncology (SSO).

The researchers in this study also found that adjuvant imatinib therapy may provide a synergistic survival benefit.

"Even taking part of the tumor, not the whole thing, you get an improvement in survival," said lead author Eduardo A. Perez, MD, general surgery resident, University of Miami Miller School of Medicine, Miami, Florida, United States, in his presentation March 24^th.

The researchers analyzed 11 years of data from the Surveillance, Epidemiology, and End Results (SEER) database. Of the 1873 tumors identified, 82% were GIST; the rest were classified as smooth-muscle neoplasms.

Median 5-year survival was significantly better for patients treated surgically compared to those who did not receive surgery. Patients who received radical resection had significantly worse survival outcomes than any other group, even those who did not get surgery.

Total resection and partial resection had similar 11-year survival curves, Dr. Perez reported. Total resection was not associated with statistically improved survival compared to partial resection (51.6% versus 44.7%). Although this finding was shown in other studies, it remains controversial, he added.

Median survival rates both overall and for individual treatment types except radical resection significantly improved after 2000. Overall 2-year survival increased from 59% to 72.9%.

"Improved outcomes after 2000 indicate the potential benefit of newer therapies, including imatinib," Dr. Perez said.

The only factors independently and significantly correlated with improved survival were treatment after the year 2000 and surgical treatment (versus no treatment).

Patients with distant disease who underwent partial or total GIST resection had a significantly improved survival rate compared to those who did not have the surgery. Dr. Perez said this result may have been due to selection bias, but "these data support a palliative therapeutic role for resection of the primary malignancy in all patients with metastatic GIST," he said.


[Presentation title: Surgery with Adjuvant Imatinib Therapy Provides a Synergistic Survival Benefit in the Treatment of Gastrointestinal Stromal Tumors. Poster 58]

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