关于巨大胃肠道间质瘤(GIST)的最佳治疗方法仍存在争议。这项回顾性研究旨在探讨巨型GIST的不同治疗方法及其对预后的影响。
将71例直径≥10cm的GIST患者根据所接受的治疗分为四组:急诊手术组(n=17),术前靶向(伊马替尼)治疗组(n=12),姑息性切除组(n=17)和R0切除组(n=25)。基线,术中和术后的结果进行了比较。进行长期随访以评估结果。
急诊手术组术前消化道出血明显高于其他组(P=0.003),血红蛋白水平明显低于其他组(P<0.05)。姑息性切除组的平均肿瘤直径明显大于其他组(P=0.023)。R0切除组和术前靶向治疗组的总生存率明显高于其他两组(P<0.05)。
在患有巨大GIST的患者中,术前伊马替尼治疗加手术或R0切除后伊马替尼治疗似乎取得了最佳结局.
Controversy persists about the best treatment for giant gastrointestinal stromal tumours (GISTs). This retrospective study aimed to investigate the different treatments for giant GISTs and the effect on outcomes.
A total of 71 patients with GIST ≥10 cm in diameter were separated into four groups according to treatment received: emergency surgery group (n = 17), preoperative targeted (imatinib) therapy group (n = 12), palliative resection group (n = 17) and R0 resection group (n = 25). Baseline, intraoperative and post-operative findings were compared between the groups. Long-term follow-up was conducted to assess outcomes.
Preoperative gastrointestinal bleeding was significantly higher (P = 0.003) and haemoglobin level was significantly lower (P < 0.05) in the emergency surgery group than in the other groups. Mean tumour diameter was significantly more in the palliative resection group than in the other groups (P = 0.023). Overall survival was significantly higher in the R0 resection group and the preoperative targeted therapy group than in the other two groups (P < 0.05).
In patients with giant GISTs, the best outcomes appear to be achieved with preoperative imatinib therapy plus surgery or R0 resection followed by imatinib therapy.