Prognosis and management of adult wild type gastrointestinal stromal tumours (GISTs): A pooled analysis and review of literature

Bhatt, Nikita; Collins, Dylan; Crotty, Paul; Ridgway, Paul F.

doi:10.1016/j.suronc.2016.05.003

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Therefore, the inclusion of single-center studies with various levels of surgical techniques might have contributed to the bias of our meta-analysis. Finally, the use of different risk classifications and drug therapies within the groups might have also contributed to the bias of recurrence or progression-free survival[ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison between laparoscopic and open surgery for large gastrointestinal stromal tumors: A meta-analysis

Cui¹,

Gao²,

Xi³

et al. 2018

WJGO

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AIMTo investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors (GISTs) (≥ 5 cm).METHODSA systematic search of PubMed, EMBASE, Web of Science and the Cochrane Library database was performed. Relevant studies of laparoscopic and open surgery for GISTs of > 5 cm published before December 2016 were identified from these databases. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The tumor size, operation time, blood loss, postoperative hospital stay, complication rate, and disease-free survival rate were assessed. The software Stata (version 12.0) was used for the meta-analysis.RESULTSFive clinical trials comprising 209 patients with GISTs of similar larger sizes were evaluated. The pooled analysis of 100 patients in the laparoscopic resection group and 109 patients in the open resection group demonstrated that laparoscopic surgery was significantly associated with a shorter postoperative hospital stay (P < 0.001) and less blood loss (P = 0.002). Moreover, there were no statistically significant differences in the operation time (P = 0.38), postoperative complication rate (P = 0.88), or disease-free survival rate (P = 0.20) between two groups.CONCLUSIONOur findings revealed that for patients with large GISTs of comparable sizes, laparoscopic surgery did not significantly influence the operation factors or clinical outcomes compared with open surgery. This suggests that laparoscopic resection is as acceptable as open surgery for treatment of large gastric GISTs.

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Section: Discussionmentioning

confidence: 99%

Comparison between laparoscopic and open surgery for large gastrointestinal stromal tumors: A meta-analysis

Cui¹,

Gao²,

Xi³

et al. 2018

WJGO

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“…Most GISTs harbor KIT/PDGFRA mutant gene named KIT/PDGFRA mutant GIST (mu-GIST), and the remaining cases (about 10–15%) are KIT/PDGFRA wild-type GISTs (wt-GIST) which do not have mutant KIT/PDGFRA genes 2 . It is important to differentiate these two subtypes of GIST for selecting effective treatment 3 . For example, imatinib is an active multikinase inhibitor that mainly targets C-kit tyrosine-kinase receptors.…”

Section: Introductionmentioning

confidence: 99%

CT-based assessment of sarcopenia for differentiating wild-type from mutant-type gastrointestinal stromal tumor

Zhou

et al. 2023

Sci Rep

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Non-invasive prediction for KIT/PDGFRA status in GIST is a challenging problem. This study aims to evaluate whether CT based sarcopenia could differentiate KIT/PDGFRA wild-type gastrointestinal stromal tumor (wt-GIST) from the mutant-type GIST (mu-GIST), and to evaluate genetic features of GIST. A total of 174 patients with GIST (wt-GIST = 52) were retrospectively identified between January 2011 to October 2019. A sarcopenia nomogram was constructed by multivariate logistic regression. The performance of the nomogram was evaluated by discrimination, calibration curve, and decision curve. Genomic data was obtained from our own specimens and also from the open databases cBioPortal. Data was analyzed by R version 3.6.1 and clusterProfiler (http://cbioportal.org/msk-impact). There were significantly higher incidence (75.0% vs. 48.4%) and more severe sarcopenia in patients with wt-GIST than in patients with mu-GIST. Multivariate logistic regression analysis showed that sarcopenia score (fitted based on age, gender and skeletal muscle index), and muscle fat index were independent predictors for higher risk of wt-GIST (P < 0.05 for both the training and validation cohorts). Our sarcopenia nomogram achieved a promising efficiency with an AUC of 0.879 for the training cohort, and 0.9099 for the validation cohort with a satisfying consistency in the calibration curve. Favorable clinical usefulness was observed using decision curve analysis. The additional gene sequencing analysis based on both our data and the external data demonstrated aberrant signal pathways being closely associated with sarcopenia in the wt-GIST. Our study supported the use of CT-based assessment of sarcopenia in differentiating the wt-GIST from the mu-GIST preoperatively.

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“…Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. 1 In recent years, with the development of multidisciplinary therapy for cancer, the therapeutic effect of GIST has been significantly improved, but surgery remains the primary and only potentially curative therapy for GIST. 2 Local resection or wedge resection can be selected according to tumor size and site.…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis on the Efficacy and Safety of Laparoscopic Surgery for Large Gastric Gastrointestinal Stromal Tumors

Wang

et al. 2020

The American Surgeon™

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Background The aim of this study was to conduct a meta-analysis comparing the safety and feasibility of laparoscopic versus open resection for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm. Method We searched the Cochrane Library, PubMed, and Embase for relevant articles. Randomized and nonrandomized clinical trials were identified and included in this study. Searching for related articles on large GIST (>5 cm) for laparoscopic resection (laparoscopic group [LAPG]) and open resection (open group [OG]), RevMan 5.3 was used for data analysis, comparing 2 groups of operation time, intraoperative blood loss, complications, length of hospital stay, recurrence rate, disease-free survival, and overall survival. Results Seven studies including 440 patients were identified for the meta-analysis. Meta-analysis revealed that LAPG had less bleeding, shorter postoperative hospital stay, and a better 5-year disease-free survival. There was no significant difference between LAPG and OG in operation time, postoperative complications, recurrence rate, and overall survival. Conclusion Laparoscopic resection of large (>5 cm) GIST is safe and feasible and has the advantages of less intraoperative blood loss and fast postoperative recovery, with a good outcome in the recent oncology.

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Prognosis and management of adult wild type gastrointestinal stromal tumours (GISTs): A pooled analysis and review of literature

Cited by 5 publications

References 22 publications

Comparison between laparoscopic and open surgery for large gastrointestinal stromal tumors: A meta-analysis

Comparison between laparoscopic and open surgery for large gastrointestinal stromal tumors: A meta-analysis

CT-based assessment of sarcopenia for differentiating wild-type from mutant-type gastrointestinal stromal tumor

Meta-Analysis on the Efficacy and Safety of Laparoscopic Surgery for Large Gastric Gastrointestinal Stromal Tumors

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