Abstract 3809
Background
Efficacy of residual lesion surgery in pts with advanced GIST responding to IM has been advocated in several retrospective studies. However, to date, no studies have identified the prognostic factors exclusively for these pts.
Methods
Between September 2002 and December 2015, a total of 107 pts with histologically documented initially metastatic or distant recurrent GIST received residual lesion surgery following disease control with IM 400 mg/day in Asan Medical Center, Seoul, Korea. Among these pts, 89 pts had complete data for potential prognostic factors and were included in the analysis.
Results
Median age was 57 years (range, 12-77) and 56 pts (62.9%) were male. Stomach (n = 41, 46.1%) and small bowel (n = 41, 46.1%) were the most common primary sites followed by peritoneum (n = 4, 4.5%). With a median follow up duration of 47.0 months (range, 16.7-174.7) from residual lesion surgery, the 5-year progression-free survival (PFS) and overall survival rates were 60.6% (95% CI, 47.3-73.9) and 85.7% (95% CI, 76.7-94.7), respectively. In multivariate analysis including potential prognostic factors, male gender (HR = 3.4, p = 0.01), presence of extra-liver metastasis (HR = 4.3, p < 0.01), and primary genotype other than KIT exon 11 mutation (HR = 7.3, p < 0.01) were independently associated with poor PFS. Compared to the good PFS (median 106.7 months) in patients with 0-2 poor prognostic factors, those with 3 factors had very poor PFS (median 8.5 months) (p < 0.001).
Conclusions
Our study confirms that long-term survival can be achieved in advanced GIST pts receiving residual lesion surgery following disease control with IM. However, further study is needed to define the role of residual lesion surgery in pts with 3 risk factors considering their poor survival outcomes.
Clinical trial identification
Legal entity responsible for the study
Asan Medical Center.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
Y-K. Kang: Consultant: Ono, BMS, Taiho, Roche, Lilly, Blueprint, Taiho, Daehwa, LSK Biopharma. All other authors have declared no conflicts of interest.
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