Similar Survival Outcomes Between Local and Radical Excision for Rectal Gastrointestinal Stromal Tumors
For patients with non-metastatic rectal gastrointestinal stromal tumors (GISTs), local and radical excisions had similar overall survival, according to a propensity-score matched analysis.
The study included 228 patients with rectal GISTs, with 127 undergoing local excision and 101 undergoing radical excision, from data collected from the National Cancer Database. After a propensity-score matched analysis was performed for clinical T-stage, tumor grade, and neoadjuvant systemic therapy, there were 52 patients in each group. The main outcomes of this study were 5-year overall survival, surgical margins, hospital stay, short-term mortality and readmission.
The 2 groups were found to have a similar mean overall survival, 139.8 months in the local excision group compared with 133.1 months in the radical excision group (P = .52). There was a significantly higher rate of positive resection margins with local excision (42.2%) compared with radical excision (19.1%; P = .02). Local excision was also associated with a shorter hospital stay, compared with radical excision (0 days vs 3 days; P < .001).
Study authors concluded, “local excision was associated with a significantly higher incidence of positive resection margins and shorter hospital stay, yet similar overall survival to radical excision.”
Source:
Hany Emile S, Horesh N, Freund MR, et al. Outcomes of local excision compared to radical excision of rectal gastrointestinal stromal tumors: A propensity-score matched analysis of the NCDB. World J Surg. 2023;47(1):269-277. doi:10.1007/s00268-022-06778-5
