Liver resection for metastatic GIST tumor improves survival in the era of tyrosine kinase inhibitors: a systematic review and meta-analysis

Rahimi-Ardabily, Arash; Murdande, Sanjana; Dong, Michael; Gu, Katie W.; Zhang, Brianna; Miller, Kendall; Aploks, Krist; Da Dong, Xiang

doi:10.1007/s00423-023-03052-7

Cited by 2 publications

(1 citation statement)

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“…In addition, the mechanism of resistance to tyrosine kinase inhibition in this population is quite different from that of patients with secondary imatinib resistance, and therefore it remains questionable to provide surgical recommendations for patients with GIST-LMs ( 18 ). Some studies have concluded that surgical resection of the primary and liver metastases is feasible, but the importance of complete resection and timing of resection should be noted ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of surgical management for gastrointestinal stromal tumor patients with liver metastasis on survival outcomes

Liu,

Xia,

et al. 2024

Front. Oncol.

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PurposeTo investigate the effect of surgical resection on survival in gastrointestinal stromal tumors synchronous liver metastasis (GIST-SLM) and to develop clinically usable predictive models for overall survival (OS) and cancer-specific survival (CSS) in patients.MethodsWe identified patients in the SEER database diagnosed with GISTs from 2010 to 2019. We used propensity score matching (PSM) to balance the bias between the Surgery and No surgery groups. Kaplan-Meier(K-M) analysis was used to detect differences in OS and CSS between the two groups. The nomogram to predict 1, 3, and 5-year OS and CSS were developed and evaluated.ResultsAfter PSM, 228 patients were included in this study. There were significant differences in 1, 3, and 5-year OS and CSS between the two groups (OS: 93.5% vs. 84.4%, 73.2% vs. 55.3%, 60.9% vs. 36.9%, P=0.014; CSS: 3.5% vs.86.2%,75.3% vs.57.9%, 62.6% vs. 42.9%, P=0.02). We also found that patients who received surgery combined with targeted therapy had better OS and CSS at 1, 3, and 5 years than those who received surgery only (OS: 96.6% vs.90.9%, 74.9% vs. 56.8%, 61.7% vs. 35.5%, P=0.022; CSS: 96.6% vs. 92.1%, 77.4% vs.59.2%,63.8% vs. 42.0%, P=0.023). The area under the curve (AUC) was 0.774, 0.737, and 0.741 for 1, 3, and 5-year OS, respectively, with 0.782 and 0.742 for 1, 3, and 5-year CSS. In the model, C-index was 0.703 for OS and 0.705 for CSS and showed good consistency.ConclusionSurgical treatment can improve the OS and CSS of patients with GIST-SLM. In addition, the combination with chemotherapy may be more favorable for the long-term survival of patients. Meanwhile, we constructed the nomograms for predicting OS and CSS at 1, 3, and 5-year, and validated them internally. Our model can contribute to clinical management and treatment strategy optimization.

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Section: Discussionmentioning

confidence: 99%