Radical resection versus local excision for low rectal gastrointestinal stromal tumor: A multicenter propensity score-matched analysis. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Wang, Tao; Zhao, Yan; Wang, Ming; Zhang, Peng; Lin, Guole; Liu, Qian; Feng, Fan; Xiong, Zhiguo; Hu, Junbo; Zhang, Bo; Ye, Yingjiang; Xia, Lijian; Tao, Kaixiong
• Is Part Of: European journal of surgical oncology. Volume 47:Issue 7(2021)
• Page Start: 1668
• Page End: 1674
• Publication Date: 2021-07
• Subjects: Rectum -- Gastrointestinal stromal tumor -- Surgery -- Propensity score matching; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2021.01.027
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Background: The surgical approaches and resection extent for rectal gastrointestinal stromal tumors (GISTs) are controversial due to the low incidence of this disease. A multicenter retrospective cohort study was conducted to compare the postoperative and oncologic outcomes of local excision (LE) and radical resection (RR) in patients with low rectal GIST. Patients and methods: The medical records of rectal GIST patients from 11 large-scale medical centers in China (January 2000-December 2019) were reviewed. All patients were divided into either the LE group or the RR group. Propensity score matching (PSM) was conducted to reduce confounders. Results: A total of 280 patients with low rectal GIST were enrolled. After PSM, 144 patients were included (72 in each group). The LE group showed a higher anal preservation rate (100.0% vs. 76.4%, P < 0.001), shorter operation time (77.1 ± 68.4 min vs. 159.1 ± 83.6 min, P < 0.001), fewer complications (8.3% vs. 22.2%, P = 0.021) and shorter postoperative hospital stay (4.9 ± 4.1 d vs. 10.7 ± 8.1 d, P < 0.001) than the RR group. There was no significant difference in recurrence-free survival (RFS) between the RR and LE groups among patients with tumors ≤2 cm ( P = 0.220), and the RR group had a superior RFS than the LE group in patients with tumors >2 cm ( P = 0.046). Conclusions: LE resulted in improved postoperative outcomes and comparable oncological safety with a low rectal GIST of ≤2 cm. However, for patients with a low rectal GIST of >2 cm, RR might be a more appropriate option with better RFS.