Postoperative imatinib treatment in gastric intermediate-risk gastrointestinal stromal tumors
Peng Zhang, Xiangyu Zeng, Xinji Wang, Xiuli Wu, Yan Li, Wenze Wan, Tao Wang, Ming Cai, Jinbo Gao, Xiaoming Shuai, Guobin Wang, Kaixiong Tao
Abstract
ObjectiveTo explore the clinical prognosis and efficacy of adjuvant therapy with imatinib of postoperative patients with gastric intermediate-risk gastrointestinal stromal tumor (GIST).
MethodsThe clinicopathological data and follow-up data of 93 gastric intermediate-risk GIST cases from Jan 2005 to Dec 2016 at Union Hospital were analyzed retrospectively. Univariate and multivariate analysis were performed to assess the prognostic factors.
ResultsThere were 93 patients undergoing complete GIST resection with 42(45%) cases receiving post-op imatinib 400 mg/d for targeted therapy. The median target therapy period was 12(6-72) months. 86% (80 cases) patients were followed up for 46(6-120) months. The 1-, 3-, 5-year recurrence-free survival rate (RFS) of the whole group were 100%, 91.5%, 88.5% respectively. Multivariate analysis revealed that mitotic count (P=0.040, RR=6.078, 95%CI: 0.541-68.274) and neutrophil-lymphocyte ratio (NLR) (P=0.036, RR=6.102, 95%CI: 0.782-47.632) were prognostic risk factors of RFS. For those mitotic count >2/50 HPF and NLR>2.3, adjuvant therapy with imatinib significantly increases RFS.
ConclusionMitotic count and NLR were independent risk factors of RFS in gastric intermediate-risk GIST. For those with mitotic count >2/50 HPF and NLR>2.3, postoperative adjuvant therapy with imatinib helps improve the prognosis.
Key words:
Gastrointestinal stromal tumors; Neoadjuvant therapy; Prognosis; Imatinib
Contributor Information
Peng Zhang
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Xiangyu Zeng
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Xinji Wang
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Xiuli Wu
Department of Pathology, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Yan Li
Department of Pathology, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Wenze Wan
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Tao Wang
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Ming Cai
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Jinbo Gao
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Xiaoming Shuai
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Guobin Wang
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Kaixiong Tao
Department of Gastrointestinal Surgery, Union Hospital, Tongi Medical College, Huazhong University of Science and Technology, Wuhan 430022, China