Clinical Analysis Of Postoperative Recurrent-metastatic Gastrointestinal Stromal Tumors

Objective:To investigate the clinical characteristics,treatment and prognostic factors of postoperative recurrent-metastatic gastrointestinal stromal tumor (GIST). Methods:Retrospective analysis of Dalian Medical University from March 1999 to March 2008 for the first time 123 cases of surgical treatment of recurrent and metastatic GIST patients the clinical features of 85 patients, treatment and assessment of prognosis.Results: 85 cases of GIST patients with a median time of recurrence was 16.8 months.Surgery alone in 16 cases, 20 cases of targeted therapy alone, surgery combined with targeted therapy in 21 cases, recurrence was first detected 42 cases of liver metastases and found that local recurrence and peritoneal metastasis in 70 cases, two transfers are available in29 cases.5 patients did not receive the follow-up, only 80 cases were followed up to evaluate the prognosis of patients.80 cases of GIST patients with 3-year survival was 75.0% in the surgery alone group, targeted therapy group was 61.1%, surgery combined with targeted therapy group was 94.4%.(1)80 cases of GIST patients older than 60 years was 48 cases, 1, 3, 5-year survival rates were 87.5%, 41.7%, 8.3%.Younger than 60 years old in 28 cases, 1, 3, 5-year survival rates were 87.5% and 78.1%, 15.6%.(2)Surgery for 34 cases in treatment group, nonsurgical treatment group for 46 cases. Surgical treatment group 1 year, 3 years, the 5-year survival rate respectively is 97.1%, 79.4%, 14.7%, the conersion 1 year, 3 years, the 5-year survival rate 80.4% 39.1%, respectively, 8.7%.(3)Targeted therapy group (oral imatinib mesylate or sunitinib malate) for the 36 cases, 44 cases of non-targeted therapy group, targeting the treatment group 1, 3, 5-year survival rates were 97.2%, 83.3%, 22.2%.Non-targeted therapy group 1, 3, 5-year survival rates were 79.5%, 34.1%,2.3%.(4)80 cases of GIST patients with primary tumor occurred in 46 cases of stomach, small intestine in 28 cases, 6 cases of colon and rectum. Univariate analysis, tumor location on prognosis of different no significant (P> 0.05).(5)Methods for tumor recurrence, tumor location, gender differences by Log-rank univariate analysis, no statistical significance (P values> 0.05). Log-rank univariate analysise revealed that age,liver metastasis,surgery and targeted therapy were related to the prognostic factors for survial(P<0.05); Multi-factor anaiysis revealed that liver metastasis , surgery and targeted therapy were the independent prognostic factors survival(P <0.05).Conclusions:Surgery and targeted therapy for recurrence and metastasis can improve survival in patients with GIST, surgery combined with targeted therapy can give GIST the best prognosis.