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Impact of surgical resection for gastrointestinal stromal tumors (GISTs) patients with initially diagnosed synchronous hepatic metastases on long-term survival outcomes
Background
The impact of surgical resection on the long-term outcome of GIST patients with initially diagnosed synchronous hepatic metastases in the targeted therapy era is still uncertain. This study aimed to investigate the role of hepatectomy in the treatment of the aforementioned patients and establish the clinical predictive models for assessing the prognosis of these patients.
Methods
We identified data of patients from the Surveillance, Epidemiology and End Results (SEER) between 2010 and 2018. The selection bias in comparisons was minimized through performing propensity score matching (PSM). The risk factors associated with cancer-specific survival (CSS) and overall survival (OS) were identified by a Cox proportional hazards model and thus established the nomograms.
Results
Of these eligible patients, there were 187(32.3%) and 336(32.3%) patients in surgical and non-surgical groups, respectively. The proportion of patients treated with surgical resection increased over time (p=0.014). Multivariate analysis revealed that the surgical resection was independent prognostic factors for OS ((hazard ratio [HR] 0.62; 95% confidence interval [CI] 0.44–0.88), p=0.0068) and CSS (HR 0.51; 95% CI 0.33 - 0.77, p=0.0016). After PSM, it was found that surgical resection still showed significantly improved OS (5-year 54.9% vs 38.8%, p = 0.028) and CSS (5-year 65.8% vs 50.3%, p=0.077). In addition, the two nomogram models demonstrated good discrimination.
Conclusions
This study revealed that the surgical resection has a favorable impact on the long-term outcome of patients with GIST liver metastases. The newly established nomograms displayed showed remarkable prediction performance for OS and CSS.
Legal entity responsible for the study
The author.
Funding
This research was supported by the National Natural Science Foundation of China (Nos. 82170543, 81770566 and 82000599), the Science and Technology Program of Sichuan Science and Technology Department (Nos. 2019YFS0029 and 2019YFS0529), and the New Medical Technology Foundation of West China Hospital of Sichuan University (No. XJS2016004). The corresponding author prof. Wentao Wang is the guarantor. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Disclosures
All authors have declared no conflicts of interest.
