Clinical characteristics and prognostic analysis of 45 patients with high-risk gastrointestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and prognosis factors of primary resectable high-risk gastrointestinal stromal tumors (GIST).</p><p><b>METHODS</b>The clinicopathological and follow-up data of 45 patients with primary resectable high-risk gastrointestinal stromal tumors between January 2002 and November 2010 were retrospectively reviewed.</p><p><b>RESULTS</b>Forty-five patients included 18 males and 27 females with a median age of 48 years (range, 28-77 years). Of 45 tumors, 19 (42.2%) located in the stomach, 9 (20.0%) in the small intestine, 7 (15.6%) in the rectum, 4 (8.9%) in the mesentery, and 6 (13.3%) in the retroperitoneum. All the patients received surgical resection and 35 (77.8%) underwent complete resection, 10 (22.2%) underwent resection of ruptured tumors (before or during operation), 33 (73.3%) underwent R0 resection, 5 (11.1%) underwent R1 resection, and 7 (15.6%) underwent R2 resection. All the patients received targeted therapy of imatinib after surgery. The median duration of imatinib was 24 (10-99) months. The main side effect was noticed in all the patients, mainly including edema in 39 (86.7%) patients and leukopenia in 27 (60.0%) patients. The relapse rate was 37.8% (17/45). The 1-, 3-, and 5-year survival rates were 100%, 86.7% and 74.4%, respectively. Univariate and multivariate analysis revealed that the degree of resection was independently associated with the prognosis of high-risk GIST patients.</p><p><b>CONCLUSIONS</b>Surgery is effective treatment for the GIST. Efforts to obtain R0 resection are important to improve the efficacy of primary resectable high-risk GIST.</p>

Clinical efficacy of surgical therapy in patients with advanced gastric cancer after pre-operative neoajnvant chemotherapy / 中国癌症杂志

Background and purpose:It is difficult to diagnose gastric cancer at an early stage,thus the resectable probability of gastric cancer is low.This study was to explore the efficacy of neoajuvant chemotherapy in terms of resectablity for the patients with advanced gastric cancer.Methods:Eighty-six patients with advanced gastric cancer were randomly divided into routine surgical operation group and neoajuvant chemotherapy+surgical operation group.The patients were examined by CT before surgery.The patients in neoajuvant chemotherapy+surgical operation group received two cycles of neoajuvant chemotherapy,and then were evaluated by CT.Results:In routine surgical operation group,the overall resectability rate was 83.7%(36/43),and the curative resection rate was 46.5%(20/43), 16.3%(7/43)was done by exp.lap.In neoajuvant chemotherapy+surgical operation group,the overall resectability rate was 93.0%(40/43),and the curative resection rate was 69.8%(30/43),only 7.0%(3/43)was exp.lap.No mortality was observed.There were no significant difference between both groups in terms of toxicities.Conclusions:The overall resectability rate and the curative resection rate are increased in patients with advanced gastric cancer aider neoajuvant chemotherapy.