Surgical management of rectal gastrointestinal stromal tumors

Authors

  • Ronald Tielen MD,

    Corresponding author
    1. Department of Surgical, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
    2. Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
    • Department of Surgical Oncology, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands; Fax: +31 24 354 0501.===

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  • Cornelis Verhoef MD, PhD,

    1. Department of Surgical Oncology, Erasmus Medical Center, Daniel Den Hoed Cancer Center, Rotterdam, The Netherlands
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  • Frits van Coevorden MD, PhD,

    1. Department of Surgical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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  • Anna K. Reyners MD, PhD,

    1. Department of Medical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
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  • Winette T.A. van der Graaf MD, PhD,

    1. Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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  • Johannes J. Bonenkamp MD, PhD,

    1. Department of Surgical, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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  • Boudewijn van Etten MD, PhD,

    1. Departmen of Surgical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
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  • Johannes H.W. de Wilt MD, PhD

    1. Department of Surgical, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Abstract

Background

Five percent of gastrointestinal stromal tumors (GISTs) are primarily localized in the rectum. We analyzed the outcome of multimodality treatment for rectal GIST in a multicenter retrospective series.

Methods

All surgically treated patients with a rectal GIST were identified from four specialized centers in the Netherlands. Primary endpoints were disease-free survival (DFS) and overall survival (OS).

Results

Thirty-two patients (22 men and 10 women) with rectal GISTs were identified. Twenty-two patients received imatinib before surgery for a median of 9 (range 2–53) months (Group 1). Ten patients received no imatinib because of small tumor size or lack of availability (Group 2). Median tumor size before treatment was 9.3 (range 6–17) cm in Group 1 and median 6 (range 4–14) cm in Group 2. A complete resection was possible in 17/22 (77%) patients in Group 1 versus 7/10 (70%) in Group 2. Median DFS was not reached in Group 1, while it was 36 months in Group 2. Median OS was not reached in both groups.

Conclusions

Preoperative imatinib leads to downsizing of the tumors in Group 1. However, it has not led to less extensive surgery. The DFS is longer in patients treated with pre- and post-operative imatinib, without an effect on OS. J. Surg. Oncol. 2013;107:320–323. © 2012 Wiley Periodicals, Inc.

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