Dhruv J Patel1, Sujay Kulshrestha2, Corinne Bunn2, Michael Littau3, Sonya Agnew2, Marshall S Baker4. 1. Loyola University Chicago Stritch School of Medicine, USA. Electronic address: dpatel27@luc.edu. 2. Department of Surgery, Loyola University Medical Center, USA. 3. Loyola University Chicago Stritch School of Medicine, USA. 4. Department of Surgery, Loyola University Medical Center, USA. Electronic address: marshall.baker@lumc.edu.
Abstract
BACKGROUND: Few studies evaluate the relationships between surgical approach, histologic margin, and overall survival in gastrointestinal stromal tumor. We test the hypothesis that margin positive resection is associated with compromised overall survival. METHODS: We queried the National Cancer Data Base to identify patients undergoing resections for gastrointestinal stromal tumors ≤3 cm in size between 2010 and 2015. Multivariable logistic regression was used to identify factors associated with positive microscopic margins on final pathology. Cox proportional hazard methods were used to evaluate factors associated with overall survival. RESULTS: 2064 patients met inclusion criteria; 135 (6.5%) had a microscopically positive surgical margin. On multivariable regression, minimally invasive approach was not associated with risk of a positive margin (OR 1.06 95% CI [0.71, 1.59]). On Cox analysis, positive margin status was not associated with OS (R1: 1.03, CI [0.46-2.31], reference R0). CONCLUSIONS: Positive microscopic surgical margins are not associated with compromised overall survival in patients undergoing resection of small gastrointestinal stromal tumors. Minimally invasive surgical approaches do not compromise oncologic outcomes in these cases.
BACKGROUND: Few studies evaluate the relationships between surgical approach, histologic margin, and overall survival in gastrointestinal stromal tumor. We test the hypothesis that margin positive resection is associated with compromised overall survival. METHODS: We queried the National Cancer Data Base to identify patients undergoing resections for gastrointestinal stromal tumors ≤3 cm in size between 2010 and 2015. Multivariable logistic regression was used to identify factors associated with positive microscopic margins on final pathology. Cox proportional hazard methods were used to evaluate factors associated with overall survival. RESULTS: 2064 patients met inclusion criteria; 135 (6.5%) had a microscopically positive surgical margin. On multivariable regression, minimally invasive approach was not associated with risk of a positive margin (OR 1.06 95% CI [0.71, 1.59]). On Cox analysis, positive margin status was not associated with OS (R1: 1.03, CI [0.46-2.31], reference R0). CONCLUSIONS: Positive microscopic surgical margins are not associated with compromised overall survival in patients undergoing resection of small gastrointestinal stromal tumors. Minimally invasive surgical approaches do not compromise oncologic outcomes in these cases.
Authors: Martin D McCarter; Cristina R Antonescu; Karla V Ballman; Robert G Maki; Peter W T Pisters; George D Demetri; Charles D Blanke; Margaret von Mehren; Murray F Brennan; Linda McCall; David M Ota; Ronald P DeMatteo Journal: J Am Coll Surg Date: 2012-07 Impact factor: 6.113
Authors: António M Gouveia; Amadeu P Pimenta; Ana F Capelinha; Dionísio de la Cruz; Paula Silva; José M Lopes Journal: World J Surg Date: 2008-11 Impact factor: 3.352
Authors: Colette S Inaba; Austin Dosch; Christina Y Koh; Sarath Sujatha-Bhaskar; Marija Pejcinovska; Brian R Smith; Ninh T Nguyen Journal: Surg Endosc Date: 2018-08-31 Impact factor: 4.584
Authors: Alessandro Gronchi; Sylvie Bonvalot; Andres Poveda Velasco; Dusan Kotasek; Piotr Rutkowski; Peter Hohenberger; Elena Fumagalli; Ian R Judson; Antoine Italiano; Hans J Gelderblom; Frits van Coevorden; Nicolas Penel; Hans-Georg Kopp; Florence Duffaud; David Goldstein; Javier Martin Broto; Eva Wardelmann; Sandrine Marréaud; Mark Smithers; Axel Le Cesne; Facundo Zaffaroni; Saskia Litière; Jean-Yves Blay; Paolo G Casali Journal: JAMA Surg Date: 2020-06-17 Impact factor: 14.766