Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy

Abstract Objective To investigate the clinicopathological features and clinical efficacy among 101 cases of rectal gastrointestinal stromal tumors (GISTs) and to investigate the significance of imatinib mesylate (IM) neoadjuvant therapy. Methods The clinicopathological features, treatment methods, p...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hongxin Yang, Chaoyong Shen, Xiaonan Yin, Zhaolun Cai, Qian Wang, Bo Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Rectal Gastrointestinal stromal tumor Neoadjuvant treatment Imatinib mesylate Disease-free survival Overall survival Surgery RD1-811
Acceso en línea:	https://doaj.org/article/b9d5338cc41841a991bfde339d4a3990
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b9d5338cc41841a991bfde339d4a3990
record_format	dspace
spelling	oai:doaj.org-article:b9d5338cc41841a991bfde339d4a39902021-11-21T12:05:54ZClinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy10.1186/s12893-021-01397-81471-2482https://doaj.org/article/b9d5338cc41841a991bfde339d4a39902021-11-01T00:00:00Zhttps://doi.org/10.1186/s12893-021-01397-8https://doaj.org/toc/1471-2482Abstract Objective To investigate the clinicopathological features and clinical efficacy among 101 cases of rectal gastrointestinal stromal tumors (GISTs) and to investigate the significance of imatinib mesylate (IM) neoadjuvant therapy. Methods The clinicopathological features, treatment methods, perioperative data, and prognosis of the patients were summarized and analysed in 101 patients with rectal GISTs who received treatment in the Gastrointestinal Surgery of West China Hospital of Sichuan University and the Affiliated Hospital of Guizhou Medical University from August 2002 to November 2020 in China. Results A total of 101 patients, including 64 males and 37 females, were aged from 22 to 79 years (55.4 ± 12.2 years). Among the 70 patients who underwent direct surgery, 8 were very low risk cases, 10 were low risk cases, 7 were intermediate risk cases, and 45 were high risk cases. Cox regression analysis showed that postoperative IM adjuvant treatment improved the disease-free survival (DFS) and overall survival (OS) of 52 intermediate and high risk patients. Among the 31 patients who received neoadjuvant therapy, the objective response rate (ORR) was 83.9% (26/31), and the disease control rate (DCR) reached 96.8% (30/31). Subgroup analysis was also conducted based on the tumour diameter. (1) Among the 36 patients with a diameter ≤ 5 cm, two patients received IM neoadjuvant therapy, while 34 patients received direct surgery. Neither univariate nor Cox regression analysis found that neoadjuvant therapy affected DFS and OS. (2) Among the 65 patients with a diameter > 5 cm, 29 received IM neoadjuvant therapy, and 36 received direct surgery. Patients who underwent neoadjuvant therapy had less blood loss (P = 0.022), shorter postoperative hospital stay (P = 0.001), increased anal retention rate (93.1% vs. 72.2%, P = 0.031), and decreased enterostomy rate (10.3% vs. 33.3%, P = 0.037) than those who underwent direct surgery. Cox regression analysis suggested that neoadjuvant therapy and postoperative IM adjuvant therapy improved DFS. Conclusion Rectal GISTs are relatively rare and highly malignant tumors. Postoperative oral IM therapy can improve the DFS and OS of intermediate and high risk patients. In patients with rectal GISTs with diameters > 5 cm, IM neoadjuvant therapy can improve anal retention rate, preserve the structure and function of the organs, reduce enterostomy rate, and improve prognosis.Hongxin YangChaoyong ShenXiaonan YinZhaolun CaiQian WangBo ZhangBMCarticleRectalGastrointestinal stromal tumorNeoadjuvant treatmentImatinib mesylateDisease-free survivalOverall survivalSurgeryRD1-811ENBMC Surgery, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Rectal Gastrointestinal stromal tumor Neoadjuvant treatment Imatinib mesylate Disease-free survival Overall survival Surgery RD1-811
spellingShingle	Rectal Gastrointestinal stromal tumor Neoadjuvant treatment Imatinib mesylate Disease-free survival Overall survival Surgery RD1-811 Hongxin Yang Chaoyong Shen Xiaonan Yin Zhaolun Cai Qian Wang Bo Zhang Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
description	Abstract Objective To investigate the clinicopathological features and clinical efficacy among 101 cases of rectal gastrointestinal stromal tumors (GISTs) and to investigate the significance of imatinib mesylate (IM) neoadjuvant therapy. Methods The clinicopathological features, treatment methods, perioperative data, and prognosis of the patients were summarized and analysed in 101 patients with rectal GISTs who received treatment in the Gastrointestinal Surgery of West China Hospital of Sichuan University and the Affiliated Hospital of Guizhou Medical University from August 2002 to November 2020 in China. Results A total of 101 patients, including 64 males and 37 females, were aged from 22 to 79 years (55.4 ± 12.2 years). Among the 70 patients who underwent direct surgery, 8 were very low risk cases, 10 were low risk cases, 7 were intermediate risk cases, and 45 were high risk cases. Cox regression analysis showed that postoperative IM adjuvant treatment improved the disease-free survival (DFS) and overall survival (OS) of 52 intermediate and high risk patients. Among the 31 patients who received neoadjuvant therapy, the objective response rate (ORR) was 83.9% (26/31), and the disease control rate (DCR) reached 96.8% (30/31). Subgroup analysis was also conducted based on the tumour diameter. (1) Among the 36 patients with a diameter ≤ 5 cm, two patients received IM neoadjuvant therapy, while 34 patients received direct surgery. Neither univariate nor Cox regression analysis found that neoadjuvant therapy affected DFS and OS. (2) Among the 65 patients with a diameter > 5 cm, 29 received IM neoadjuvant therapy, and 36 received direct surgery. Patients who underwent neoadjuvant therapy had less blood loss (P = 0.022), shorter postoperative hospital stay (P = 0.001), increased anal retention rate (93.1% vs. 72.2%, P = 0.031), and decreased enterostomy rate (10.3% vs. 33.3%, P = 0.037) than those who underwent direct surgery. Cox regression analysis suggested that neoadjuvant therapy and postoperative IM adjuvant therapy improved DFS. Conclusion Rectal GISTs are relatively rare and highly malignant tumors. Postoperative oral IM therapy can improve the DFS and OS of intermediate and high risk patients. In patients with rectal GISTs with diameters > 5 cm, IM neoadjuvant therapy can improve anal retention rate, preserve the structure and function of the organs, reduce enterostomy rate, and improve prognosis.
format	article
author	Hongxin Yang Chaoyong Shen Xiaonan Yin Zhaolun Cai Qian Wang Bo Zhang
author_facet	Hongxin Yang Chaoyong Shen Xiaonan Yin Zhaolun Cai Qian Wang Bo Zhang
author_sort	Hongxin Yang
title	Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
title_short	Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
title_full	Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
title_fullStr	Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
title_full_unstemmed	Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
title_sort	clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b9d5338cc41841a991bfde339d4a3990
work_keys_str_mv	AT hongxinyang clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy AT chaoyongshen clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy AT xiaonanyin clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy AT zhaoluncai clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy AT qianwang clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy AT bozhang clinicopathologicalfeaturesclinicalefficacyon101casesofrectalgastrointestinalstromaltumorsandthesignificanceofneoadjuvanttherapy
_version_	1718419268088889344

Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy

Ejemplares similares