Case Reports in Oncological Medicine / 2017 / Article / Tab 2

Case Report

Recurrent Gastrointestinal Stromal Tumors in the Imatinib Mesylate Era: Treatment Strategies for an Incurable Disease

Table 2

Institutional studies demonstrating benefit of surgery for recurrent GIST.

Study designNumber of patientsPrimary endpointR0 resectionMain findings

Bischof et al. [1]Multi-institutional retrospective cohort158 (87 locally advanced, 71 recurrent/metastatic)RFS, OS69% (recurrent/metastatic) versus 87.4% (locally advanced)TKI-sensitive recurrent/metastatic disease—improved RFS, OS after surgery

Du et al. [43]Phase III multicenter trial for recurrent/metastatic on IM +/− surgery for residual disease41 (19 IM + surgery, 22 IM alone)PFS73.6%Trend towards improved PFS in surgery group

Tan et al. [13]Retrospective cohort—upfront surgery versus TKI for recurrence186 (56 recurrent—30 resectable, 24 underwent surgery for recurrence)DFS, OS75% (18 of 24) in upfront surgery groupImproved OS and DFS with surgery

Chang et al. [17]Prospectively collected retrospective review—imatinib + surgery (early versus late groups) versus IM only182 (89 metastatic, 93 recurrent, 76 underwent surgery)Clinical response, PFS, OS31.5% (early surgery) versus 59.1% (late surgery)Improved CR, PR, PFS, OS in early surgery group; improved CR, PR, OS in late surgery group

Sato et al. [25]Retrospective cohort comparing IM + surgery to surgery only737 (93 recurrent/metastatic—50 surgery + TKI therapy, 43 TKI therapy alone)DFI, OS58% (29 of 50)Improved survival from surgery + TKI after complete resection, response to TKI, < 4 metastatic lesions, lesions < 100 mm total

TKI = tyrosine kinase inhibitor, IM = imatinib mesylate, OS = overall survival, DFS = disease-free survival, PFS = progression-free survival, CR = complete response, PR = partial response, RFS = recurrence-free survival, DFI = disease-free interval.