Long-term outcomes of endoscopic therapy versus surgical resection for 2-5cm gastric gastrointestinal stromal tumors: A population-based comparative study
Menée à partir de données des registres américains des cancers portant sur 749 patients atteints de tumeurs stromales gastro-intestinales mesurant 2 à 5 cm, cette étude analyse la survie à 5 ans après une chirurgie par voie endoscopique ou non
Background: Endoscopic technology (ET) of gastrointestinal stromal tumors (GIST) has become a viable treatment. We intended to compare long-term outcomes of ET versus surgical resection for 2–5 cm GIST using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: A multicenter retrospective study was conducted to compare the long-term outcomes of patients treated with ET and surgical treatment for GIST. The multivariate Cox proportional hazards models (Cox models) were used to identify predictors for patients survival. To balance the clinicopathologic characteristics, a 1:1 propensity score matching (PSM) was utilized. Results: A total of 749 patients with 2–5 cm GIST were enrolled, of whom 113 accepted ET and 636 underwent surgical resection. Before PSM, there was no significant difference in long-term outcome between ET and surgical resection (5-year overall survival (OS): 93.5% vs. 91.6%; 5-year cancer-specific survival (CSS): 99.1% vs. 96.5%; 10-year OS: 71.1% vs. 78.2%; 10-year CSS: 93.6% vs. 92.7%). By using Cox models, we observed that the ET and surgical resection groups were similar in OS and CSS. After PSM, the long-term OS and CSS of patients with 2–5 cm GIST after ET and surgical resection were comparable. Conclusions: We found that the long-term survival of patients with 2–5 cm gastric GIST after ET and surgical resection were comparable. Further high-quality studies are needed to confirm the role of ET in 2–5 cm GIST.