Management of complicated tumor response to tyrosine-kinase inhibitors in gastrointestinal stromal tumors.
Antineoplastic Agents
/ adverse effects
Female
Gastrointestinal Neoplasms
/ drug therapy
Gastrointestinal Stromal Tumors
/ drug therapy
Humans
Imatinib Mesylate
/ adverse effects
Incidence
Male
Middle Aged
Postoperative Complications
/ epidemiology
Protein Kinase Inhibitors
/ adverse effects
Retrospective Studies
Sunitinib
/ adverse effects
emergency surgery
gastrointestinal stromal tumor
imatinib
sarcoma
tyrosine-kinase inhibitors
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
16
04
2019
accepted:
20
04
2019
pubmed:
9
5
2019
medline:
20
7
2019
entrez:
9
5
2019
Statut:
ppublish
Résumé
The aim was to describe complicated tumor response (CTR) to tyrosine-kinase inhibitors (TKI) in gastrointestinal stromal tumors (GIST) patients. From 2001 to 2017, data from patients with metastatic (group A) or locally advanced (group B) GIST who received TKI at our institution were collected. We defined CTR as bleeding, abscess, or perforation as surgical complications of TKI. Patients who had progressive disease were excluded. Clinical characteristics were assessed, and time of occurrence and mortality rate recorded. Among 470 patients, 30 developed CTR (6.4%), 26 in group A (6.8%) and four in group B (4.5%) (P = 0.43). Bleeding, abscess, and perforation, respectively, were observed in 17 (56.7%), 8 (26.7%), and 5 (16.7%) patients. A conservative approach was possible in 17 (56.7%) cases; four (13.3%) patients received percutaneous drainage, while nine (30%) underwent emergency surgery. The overall rate of mortality was 13.3%. CTR occurred after 1.6 months (median time) from the imatinib mesylate onset in group B and 14 months in group A. While the risk of CTR in early metastatic patients is virtually nil, patients with locally advanced disease should be monitored carefully. CTR as a consequence of TKI therapy do not prevent patients receiving a potentially curative surgery.
Sections du résumé
BACKGROUND
BACKGROUND
The aim was to describe complicated tumor response (CTR) to tyrosine-kinase inhibitors (TKI) in gastrointestinal stromal tumors (GIST) patients.
METHODS
METHODS
From 2001 to 2017, data from patients with metastatic (group A) or locally advanced (group B) GIST who received TKI at our institution were collected. We defined CTR as bleeding, abscess, or perforation as surgical complications of TKI. Patients who had progressive disease were excluded. Clinical characteristics were assessed, and time of occurrence and mortality rate recorded.
RESULTS
RESULTS
Among 470 patients, 30 developed CTR (6.4%), 26 in group A (6.8%) and four in group B (4.5%) (P = 0.43). Bleeding, abscess, and perforation, respectively, were observed in 17 (56.7%), 8 (26.7%), and 5 (16.7%) patients. A conservative approach was possible in 17 (56.7%) cases; four (13.3%) patients received percutaneous drainage, while nine (30%) underwent emergency surgery. The overall rate of mortality was 13.3%. CTR occurred after 1.6 months (median time) from the imatinib mesylate onset in group B and 14 months in group A.
CONCLUSIONS
CONCLUSIONS
While the risk of CTR in early metastatic patients is virtually nil, patients with locally advanced disease should be monitored carefully. CTR as a consequence of TKI therapy do not prevent patients receiving a potentially curative surgery.
Substances chimiques
Antineoplastic Agents
0
Protein Kinase Inhibitors
0
Imatinib Mesylate
8A1O1M485B
Sunitinib
V99T50803M
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
256-261Informations de copyright
© 2019 Wiley Periodicals, Inc.