【摘要】 目的研究晚期胃肠间质瘤患者经过了酪氨酸激酶抑制剂治疗后接受姑息手术的安全性和对预后的影响。方法回顾性研究选取中山大学肿瘤防治中心2002年1月~2008年12月间治疗晚期胃肠间质瘤患者,分成两组,手术组和未手术组。两组分别比较临床病理因素和预后的差异。结果总共有156例患者入组本研究,其中87例患者接受了姑息手术的,69例患者未接受手术治疗,两组临床病理因素并无明显差异。接受手术的患者中,共有4例(4.6%)患者出现了手术相关并发症,无手术相关死亡。中位随访时间23.7个月,手术组患者其总体生存时间(Overall Survival,OS)和无进展生存时间(Progression-free Survival,PFS)均明显长于未手术组患者,中位PFS分别为46.1个月(手术组)和33.8个月(未手术组),两组2年无疾病生存率分别为:89.7%vs 85.5%,P<0.01,结果具有显著的统计学差异。类似的,中位OS在两组分别为54.8个月(手术组)和40.4个月(未手术组),P<0.01,结果具有统计学意义。亚组分析发现,不论是原发于胃或非胃,原发突变位于c-KIT外显子11,手术组预后均好于非手术组。结论晚期胃肠间质瘤患者酪氨酸激酶抑制剂后反应有效的患者,手术安全性良好,接受手术可改善患者预后。更多还原

【Abstract】 Objective To study the safety and clinical benefits of the advanced gastrointestinal stromal tumor(GIST) patients who underwent palliative surgery after tyrosine kinase inhibitors(TKIs)treatment. Methods We evaluated the safety and outcomes in a single institution series of advanced GIST patients from January 2002 to December 2008. Patients were categorized into two groups based on whether underwent surgical resection. Results 156 patients had been recruited in this study,including 87 patients underwent surgical resection and 69 patients kept on TKIs treatment. There was no difference in the clinicopathological features between two groups, and 4 patients had surgical complications. Median follow-up was 23.7 months. The OS and PFS of the patients in surgical group were longer than the non-surgical group, PFS : 46.1 months vs 33.8 months(P <0.01), OS : 54.8months vs 40.4 months and the 2 years progression-free disease rate was 89.7% vs 85.5%,P <0.01,respectively. Conclusion Patients with advanced GISTs have prolonged overall survival after debulking procedures. Surgery for patients with metastatic GIST who have responsive disease after TKIs treatment should be considered.更多还原