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Article
Duodenal GI stromal tumors: Is radical resection necessary?
Journal of surgical oncology
  • Abhineet Uppal, John Wayne Cancer Institute at Providence Saint John's Hospital, Santa Monica, CA
  • Mansen Wang, Medical Data Research Center, Providence Saint Joseph's Health, Portland, Oregon
  • Trevan D Fischer, Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
  • Melanie Goldfarb, John Wayne Cancer Institute
Document Type
Article
Publication Date
8-10-2019
Disciplines
Abstract

BACKGROUND AND OBJECTIVES: Duodenal gastrointestinal stromal tumors (GISTs) are rare tumors that pose a surgical challenge, and long-term outcomes after resection have not been detailed outside of small case series. This study uses the National Cancer Database (NCDB) to examine the determinants of radical resection for duodenal GISTs as well as the impact of local vs radical resection on overall survival (OS).

METHODS: The NCDB was queried for nonmetastatic duodenal GISTs from 2004 to 2014. Predictors of radical resection were determined using multivariate logistic regression stratified by extent of tumor involvement. Factors associated with OS were identified with Cox proportional regression analysis.

RESULTS: Treatment at an academic center, size >5 cm, and extra-duodenal extension were associated with radical resection. On multivariate analysis, radical resection was associated with decreased OS (HR, 1.93; P < .03). Systemic therapy, extra-duodenal extension, grade, stage, mitoses, and receipt of systemic therapy did not impact OS.

CONCLUSION: Local resection of duodenal GISTs is associated with improved OS compared to radical resection after controlling for tumor factors and systemic treatment. Traditional indicators of tumor aggressiveness were associated with radical resection, but not OS. When feasible, local resection should be considered for resection of duodenal GISTs.

Clinical Institute
Cancer
Clinical Institute
Digestive Health
Department
Oncology
Department
Surgery
Department
Gastroenterology
Citation Information
Abhineet Uppal, Mansen Wang, Trevan D Fischer and Melanie Goldfarb. "Duodenal GI stromal tumors: Is radical resection necessary?" Journal of surgical oncology (2019)
Available at: http://works.bepress.com/mansen-wang/5/