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Microscopically Positive Resection Margin Has No Influence on OS, RFS in GIST
R1 margins did not significantly influence overall survival (OS) and relapse-free survival (RFS) after resection compared with R0 margins in patients with gastrointestinal stromal tumors (GISTs), according to results from a retrospective study (Am J Surg. 2020 Aug. Epub ahead of print).
“Surgery represents the best treatment for primary [GIST],” wrote Gianni Pantuso, MD, University of Palermo, Italy, and co-investigators, who sought to analyze outcomes of surgical management and evaluate the influence of microscopically R1 margins on survival and disease recurrence in patients with GIST.
A total of 74 patients surgically treated for primary GISTs without metastasis at diagnosis were included in the study. Dr Pantuso et al analyzed clinical and pathologic findings, surgical procedures, and information about follow-up and outcomes.
The OS and RFS were the primary end points.
RFS for patients undergoing R0 (n = 54) resection versus R1 (n = 20) resection was 76% versus 85% at 3 years (P = .14) and 63% versus 86% at 5 years (P = .48), respectively. The difference was not statistically significant.
There were no patient deaths reported in the R1 group during the follow-up period, and the recurrence rate was low.
Ultimately, the investigators found that microscopically positive margin has no influence on OS and RFS in patients with GIST.
“Thus, when R0 surgery implies major functional sequelae, it may be decided to accept possible R1 margins, especially for low risk tumors,” they concluded.—Kaitlyn Manasterski
