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Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors.

Publication ,  Journal Article
Rhodin, KE; DeLaura, IF; Horne, E; Bartholomew, A; Howell, TC; Kanu, E; Masoud, S; Lidsky, ME; Nussbaum, DP; Blazer, DG
Published in: J Gastrointest Surg
October 2023

BACKGROUND: Society guidelines remain inconsistent on the role of endoscopic and radiographic surveillance as an alternative to surgical resection of small gastric gastrointestinal stromal tumors (GISTs). Herein, we aimed to assess survival among patients with gastric GISTs undergoing observation versus surgical resection, stratified by tumor size. METHODS: The National Cancer Database (NCDB) was queried for gastric GISTs < 2 cm diagnosed from 2010-2017. Patients were stratified by management strategy-observation vs surgical resection. The primary outcome, overall survival (OS), was examined with Kaplan-Meier and multivariable Cox proportional hazard methods. Subgroup analyses were conducted on tumors < 1 cm and 1-2 cm in size. RESULTS: Altogether, 1208 patients were identified: 439 (36.3%) undergoing observation and 769 (63.7%) receiving surgical resection. In the overall cohort, patients undergoing surgical resection demonstrated improved survival (93.6 vs. 88.8% 5-year OS, p=0.02). In multivariable analysis, upfront surgical resection was not associated with a reduction in mortality; however, there was a significant interaction with tumor size. For patients with tumors < 1 cm, there was no difference in survival based on management strategy. However, resection of tumors 1-2 cm was associated with improved survival relative to surveillance. CONCLUSIONS: While surgical resection and surveillance were associated with similar survival for patients with gastric GISTs < 1 cm, this NCDB analysis suggests that patients with tumor size ≥ 1 cm may benefit from upfront surgical resection. Prospective studies comparing these two approaches and their impact on recurrence-free and disease-specific survival are needed to better align consensus guidelines and recommendations.

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Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

October 2023

Volume

27

Issue

10

Start / End Page

2076 / 2084

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Stomach Neoplasms
  • Retrospective Studies
  • Prospective Studies
  • Laparoscopy
  • Humans
  • Gastrointestinal Stromal Tumors
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Rhodin, K. E., DeLaura, I. F., Horne, E., Bartholomew, A., Howell, T. C., Kanu, E., … Blazer, D. G. (2023). Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors. J Gastrointest Surg, 27(10), 2076–2084. https://doi.org/10.1007/s11605-023-05779-6
Rhodin, Kristen E., Isabel F. DeLaura, Elizabeth Horne, Alex Bartholomew, Thomas C. Howell, Elishama Kanu, Sabran Masoud, Michael E. Lidsky, Daniel P. Nussbaum, and Dan G. Blazer. “Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors.J Gastrointest Surg 27, no. 10 (October 2023): 2076–84. https://doi.org/10.1007/s11605-023-05779-6.
Rhodin KE, DeLaura IF, Horne E, Bartholomew A, Howell TC, Kanu E, et al. Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors. J Gastrointest Surg. 2023 Oct;27(10):2076–84.
Rhodin, Kristen E., et al. “Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors.J Gastrointest Surg, vol. 27, no. 10, Oct. 2023, pp. 2076–84. Pubmed, doi:10.1007/s11605-023-05779-6.
Rhodin KE, DeLaura IF, Horne E, Bartholomew A, Howell TC, Kanu E, Masoud S, Lidsky ME, Nussbaum DP, Blazer DG. Impact of Tumor Size and Management on Survival in Small Gastric Gastrointestinal Stromal Tumors. J Gastrointest Surg. 2023 Oct;27(10):2076–2084.
Journal cover image

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

October 2023

Volume

27

Issue

10

Start / End Page

2076 / 2084

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Stomach Neoplasms
  • Retrospective Studies
  • Prospective Studies
  • Laparoscopy
  • Humans
  • Gastrointestinal Stromal Tumors
  • 3202 Clinical sciences
  • 1103 Clinical Sciences