Surgical management of rectal gastrointestinal stromal tumors

• Published in: Journal of surgical oncology Vol. 107; no. 4; pp. 320 - 323
• Main Authors: Tielen, Ronald, Verhoef, Cornelis, van Coevorden, Frits, Reyners, Anna K., van der Graaf, Winette T.A., Bonenkamp, Johannes J., van Etten, Boudewijn, de Wilt, Johannes H.W.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2013; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Benzamides; Chemotherapy, Adjuvant; Digestive System Surgical Procedures - methods; Disease-Free Survival; Female; Follow-Up Studies; gastrointestinal stromal tumor; Gastrointestinal Stromal Tumors - drug therapy; Gastrointestinal Stromal Tumors - mortality; Gastrointestinal Stromal Tumors - pathology; Gastrointestinal Stromal Tumors - surgery; Humans; imatinib; Imatinib Mesylate; Incidence; Kaplan-Meier Estimate; Male; Middle Aged; Neoadjuvant Therapy - methods; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging; Netherlands; Piperazines - therapeutic use; Pyrimidines - therapeutic use; rectal; Rectal Neoplasms - drug therapy; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Retrospective Studies; surgery; Treatment Outcome; Netherlands
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.23223

Background Five percent of gastrointestinal stromal tumors (GISTs) are primarily localized in the rectum. We analyzed the outcome of multimodality treatment for rectal GIST in a multicenter retrospective series. Methods All surgically treated patients with a rectal GIST were identified from four specialized centers in the Netherlands. Primary endpoints were disease‐free survival (DFS) and overall survival (OS). Results Thirty‐two patients (22 men and 10 women) with rectal GISTs were identified. Twenty‐two patients received imatinib before surgery for a median of 9 (range 2–53) months (Group 1). Ten patients received no imatinib because of small tumor size or lack of availability (Group 2). Median tumor size before treatment was 9.3 (range 6–17) cm in Group 1 and median 6 (range 4–14) cm in Group 2. A complete resection was possible in 17/22 (77%) patients in Group 1 versus 7/10 (70%) in Group 2. Median DFS was not reached in Group 1, while it was 36 months in Group 2. Median OS was not reached in both groups. Conclusions Preoperative imatinib leads to downsizing of the tumors in Group 1. However, it has not led to less extensive surgery. The DFS is longer in patients treated with pre‐ and post‐operative imatinib, without an effect on OS. J. Surg. Oncol. 2013;107:320–323. © 2012 Wiley Periodicals, Inc.