Small-sized gastrointestinal stromal tumors: Is there an association between expectant management and overall survival?

Small-sized gastrointestinal stromal tumors (GISTs) have limited malignant potential. Few studies evaluate the safety and efficacy of expectant management (EM) for patients presenting with small GIST. We queried the National Cancer Database to identify patients ≤65 years presenting with GISTs smalle...

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Bibliographic Details
Published in:The American journal of surgery 2022-03, Vol.223 (3), p.521-525
Main Authors: Patel, Dhruv J., Bunn, Corinne, Kulshrestha, Sujay, Tonelli, Celsa, Littau, Michael, Kim, Preston, Luchette, Fred, Abdelsattar, Zaid, Baker, Marshall S.
Format: Article
Language:English
Subjects:
Biopsy
Cancer
Gastrointestinal cancer
Gastrointestinal Stromal Tumors - surgery
Humans
Kaplan-Meier Estimate
Mortality
Overall survival
Patients
Resection
Retrospective Studies
Small GIST
Statistical analysis
Stomach
Stomach Neoplasms - surgery
Surveillance
Survival
Survival analysis
Tumors
Watchful Waiting
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Summary:Small-sized gastrointestinal stromal tumors (GISTs) have limited malignant potential. Few studies evaluate the safety and efficacy of expectant management (EM) for patients presenting with small GIST. We queried the National Cancer Database to identify patients ≤65 years presenting with GISTs smaller than 3 cm in size between 2004 and 2015. Patients undergoing EM were 1:3 propensity score matched for relevant covariates to patients undergoing resection. Kaplan-Meier (KM) analysis of matched cohorts was used to evaluate the association between EM and overall survival (OS). 1330 patients met inclusion criteria; 966 (72.6%) had gastric GISTs. 1196 (89.9%) underwent resection; 134 (10.1%) EM. 117 patients undergoing EM were propensity-matched to 356 patients undergoing resection. There was no difference in 5-year OS between patients undergoing EM and those undergoing resection (95.7% vs 92.6%, p = 0.4882). Survival for small GISTs is similar with expectant management or resection. •Tumor location is a predictor of expectant management (EM) for small (≤3CM) GIST.•No significant difference in OS between EM and resection for small GIST.•Female sex and private insurance are predictors of improved survival for small GIST.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2021.12.015