Imatinib-resistant gastrointestinal stromal tumors in the er
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Imatinib resistance is associated with a poor prognosis in patients with gastrointestinal stromal tumors. Surgical resection is associated with better survival, states a recent study published by the Surgery.

Although novel tyrosine kinase inhibitors have improved outcomes in imatinib-resistant gastrointestinal stromal tumors, the role of resection remains unclear. Researchers sought to investigate factors predictive of overall and progression-free survival in patients with imatinib-resistant gastrointestinal stromal tumors.

A query of prospectively maintained Comprehensive Cancer Center registry was performed for patients with imatinib-resistant gastrointestinal stromal tumors. Clinicopathologic characteristics and medical and surgical treatments were collected; overall survival and progression-free survival after imatinib resistance were analyzed with Kaplan-Meier and Cox proportional hazards modeling.

A total of 84 patients developed imatinib resistance at a median age of 59 years. Median time to imatinib resistance after diagnosis and overall survival after imatinib resistance was 50 and 51 months, respectively.

-- After being diagnosed with imatinib resistance, 17 patients underwent resection.

--On multivariable analysis, resection after imatinib resistance was independently associated with improved progression-free survival but not overall survival.

--Similar findings were found on subgroup analysis of patients treated with second-line sunitinib.

Conclusively, long-term survival can be achieved in patients who develop imatinib-resistant gastrointestinal stromal tumors. Surgical resection of imatinib-resistant gastrointestinal stromal tumors is associated with improved progression-free survival and should be considered in selected patients.

Source: https://doi.org/10.1016/j.surg.2021.05.009
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