Outcome of metastatic GIST in the era before tyrosine kinase inhibitors

Gold, J. S., van der Zwan, S. M., Gonen, M., Maki, R. G., Singer, S., Brennan, M. F., Antonescu, C. R., De Matteo, R. P. (January 2007) Outcome of metastatic GIST in the era before tyrosine kinase inhibitors. Ann Surg Oncol, 14 (1). pp. 134-42. ISSN 1068-9265 (Print)1068-9265 (Linking)

URL: https://www.ncbi.nlm.nih.gov/pubmed/17080234
DOI: 10.1245/s10434-006-9177-7

Abstract

BACKGROUND: Treatment of metastatic GIST with imatinib mesylate results in a 2-year survival of approximately 72%. The outcome of patients with metastatic GIST not treated with tyrosine kinase inhibitors is not well defined. METHODS: One hundred nineteen patients with metastatic GIST diagnosed prior to July 1, 1998 (approximately 2 years prior to the use of imatinib for GIST) were identified from an institutional database of patients with pathologically confirmed GIST. Mutational analysis was performed in cases with available tissue. The log rank test and Cox regression models were used to assess prognostic factors. RESULTS: Median survival was 19 months with a 41% 2-year survival and a 25% 5-year survival. Resection of metastatic GIST was performed in 81 patients (68%), while 50 (42%) received conventional chemotherapy. Twelve patients (10%) were eventually started on imatinib. Primary tumor size <10 cm, <5 mitoses/50 HPF in the primary tumor, epithelioid morphology, longer disease-free interval, and surgical resection were independent predictors of improved survival on multivariate analysis. Mutational status did not predict outcome. In patients who underwent resection, the 2 year survival was 53%, and negative microscopic margins also independently predicted improved survival. CONCLUSIONS: Treatment with imatinib appears to improve 2-year survival of metastatic GIST by approximately 20% when compared to surgery alone. The combination of imatinib and surgery for the treatment of metastatic GIST therefore warrants investigation.

Item Type: Paper
Uncontrolled Keywords: Adult Aged Aged, 80 and over Antineoplastic Agents/*therapeutic use Benzamides Female Gastrointestinal Neoplasms/mortality/*pathology/therapy Gastrointestinal Stromal Tumors/mortality/*secondary/*therapy Humans Imatinib Mesylate Male Middle Aged Piperazines/*therapeutic use Prognosis Protein Kinase Inhibitors/*therapeutic use Pyrimidines/*therapeutic use Survival Rate
Subjects: diseases & disorders > cancer > drugs and therapies
diseases & disorders > cancer > cancer types > gastrointestinal stromal tumors
diseases & disorders > cancer > metastasis
diseases & disorders > cancer > prognosis
CSHL Authors:
Communities: CSHL labs > Maki lab
Depositing User: Matt Covey
Date: January 2007
Date Deposited: 26 Oct 2016 19:13
Last Modified: 26 Oct 2016 19:13
Related URLs:
URI: http://repository.cshl.edu/id/eprint/33672

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