Title :

Prognostic impact of positive microscopic margins (R1 resection) in patients with GIST (gastrointestinal stromal tumours): Results of a multicenter European study

Author(s) :

Thibaut, Flore [Auteur]
Hôpital Claude Huriez [Lille]
Centre Hospitalier de Seclin
Veziant, Julie [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Warlaumont, Maxime [Auteur]
Hôpital Claude Huriez [Lille]
Gauthier, Victoria [Auteur]
Institut Pasteur de Lille
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lefèvre, Jeremie [Auteur]
CHU Saint-Antoine [AP-HP]
Sorbonne Université [SU]
Gronnier, Caroline [Auteur]
Université de Bordeaux [UB]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bonnet, Stephane [Auteur]
Institut Mutualiste de Montsouris [IMM]
Mabrut, Jean‐yves [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Régimbeau, Jean-Marc [Auteur]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Chirurgie digestive [CHU Amiens]
Benhaim, Leonor [Auteur]
Institut Gustave Roussy [IGR]
Tiberio, G [Auteur]
Università degli Studi di Brescia = University of Brescia [UniBs]
Mathonnet, Muriel [Auteur]
Hôpital Dupuytren [CHU Limoges]
Regenet, Nicolas [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Chirica, Mircea [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Glehen, Olivier [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Mariani, Pascale [Auteur]
Institut Curie [Paris]
Panis, Yves [Auteur]
Clinique Hartmann [Neuilly-sur-Seine]
Genser, Laurent [Auteur]
Nutrition et obésités: approches systémiques (UMR-S 1269) [Nutriomics]
CHU Pitié-Salpêtrière [AP-HP]
Mutter, Didier [Auteur]
l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Thereaux, Jeremie [Auteur]
Nutrition, Métabolismes et Cancer [NuMeCan]
Hôpital de la Cavale Blanche
Bergeat, Damien [Auteur]
Centre Hospitalier Universitaire [Rennes]
Le Roy, Bertrand [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Brigand, Cécile [Auteur]
Hôpital de Hautepierre [Strasbourg]
Eveno, Clarisse [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Piessen, Guillaume [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]

Journal title :

EJSO - European Journal of Surgical Oncology

Pages :

108310

Publisher :

WB Saunders

Publication date :

2024-06

ISSN :

0748-7983

English keyword(s) :

GIST
R1 resection
Microscopic positive margins
Tumor rupture

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BackgroundAlthough several prognostic factors in GIST have been well studied such as tumour size, mitotic rate, or localization, the influence of microscopic margins or R1 resection remains controversial. The aim of this ...
Show more >BackgroundAlthough several prognostic factors in GIST have been well studied such as tumour size, mitotic rate, or localization, the influence of microscopic margins or R1 resection remains controversial. The aim of this study was to evaluate the influence of R1 resection on the prognosis of GIST in a large multicentre retrospective series of patients.MethodsFrom 2001 to 2013, 1413 patients who underwent surgery for any site of GIST were identified from 61 European centres. 1098 patients were included, excluding synchronous metastases, concurrent malignancies, R2 resection or GIST recurrence. Tumour rupture (TR) was reclassified according to the Oslo sarcoma classification. Cox proportional hazards ratio and Kaplan-Meier survival estimates were used to analyse 5-year recurrence-free survival (RFS).ResultsOf 1098 patients, 38 (3%) underwent R1 resection with a risk of TR of 11%. The 5-year RFS was 89.6% with a median follow-up of 81 months [range: 31.2–152 months]. On univariate analysis, lower RFS was significantly associated with R1 resection [HR = 2.13; p = 0.04], high risk score according to the modified NIH classification, administration of adjuvant therapy [HR = 2.24; p < 0.001] and intraoperative complications [HR = 2.82; p < 0.001]. Only intraoperative complications [HR = 1.79; p = 0.02] and high risk according to the modified NIH classification including the updated definition of TR [HR = 3.43; p = 0.04] remained significant on multivariate analysis.ConclusionThis study shows that positive microscopic margins are not an independent predictive factor for RFS in GIST when taking into account the up-dated classification of TR. R1 resection may be considered a reasonable alternative to avoid major functional sequelae and should not lead to reoperation.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL