Comparison of the treatment outcomes of endoscopic and surgical resection of GI stromal tumors in the stomach: a propensity score–matched case-control study
We aimed to investigate the safety and efficacy of endoscopic resection (ER) compared with surgical resection (SR) of gastric GI stromal tumors (GISTs). This study included 51 and 403 patients who underwent ER and SR, respectively, for ≤5 cm GISTs in the stomach between June 2005 and August 2017. Af...
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| Veröffentlicht in: | Gastrointestinal endoscopy 2020-03, Vol.91 (3), p.527-536 |
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| creator | Kim, Ga Hee Choi, Kee Don Gong, Chung Sik Lee, In-Seob Park, Young Soo Han, Minkyu Na, Hee Kyong Ahn, Ji Yong Lee, Jeong Hoon Jung, Kee Wook Kim, Do Hoon Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong |
| description | We aimed to investigate the safety and efficacy of endoscopic resection (ER) compared with surgical resection (SR) of gastric GI stromal tumors (GISTs).
This study included 51 and 403 patients who underwent ER and SR, respectively, for ≤5 cm GISTs in the stomach between June 2005 and August 2017. After propensity score matching (1:1) using age, sex, tumor size, mitotic count, and comorbidities, the oncologic outcomes were compared with 48 patients each from ER and SR groups.
The ER group had significantly shorter hospital stay (4.4 ± 2.9 vs 6.6 ± 3.6 days, P < .001) and procedure time (38.3 ± 24.2 vs 66 ± 33.3 min, P < .001). The R0 resection rate was 62.7% in the ER group and 98.5% in the SR group. In the ER group, macroperforation occurred in 6 patients (11.8%) with a tumor located in the fundus (4/6, 66.7%) or body (2/6, 33.3%). All cases of perforation were cured with conservative treatment. In the SR group, postoperative adverse events such as stricture and leakage occurred in 7 patients (1.7%) with a tumor located in the antrum (4/7, 57.1%) or cardia (3/7, 42.9%). After matching, the overall mean follow-up period was 47.9 ± 37.8 months in the ER group and 41.3 ± 22.6 months in the SR group. No recurrence or distant metastasis occurred in either group during the follow-up period.
ER is an effective and safe therapeutic method that might be comparable with SR for treating small-sized (≤5 cm) gastric GISTs. Selecting the resection method according to the tumor location seems appropriate. |
| doi_str_mv | 10.1016/j.gie.2019.10.020 |
| format | Article |
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This study included 51 and 403 patients who underwent ER and SR, respectively, for ≤5 cm GISTs in the stomach between June 2005 and August 2017. After propensity score matching (1:1) using age, sex, tumor size, mitotic count, and comorbidities, the oncologic outcomes were compared with 48 patients each from ER and SR groups.
The ER group had significantly shorter hospital stay (4.4 ± 2.9 vs 6.6 ± 3.6 days, P < .001) and procedure time (38.3 ± 24.2 vs 66 ± 33.3 min, P < .001). The R0 resection rate was 62.7% in the ER group and 98.5% in the SR group. In the ER group, macroperforation occurred in 6 patients (11.8%) with a tumor located in the fundus (4/6, 66.7%) or body (2/6, 33.3%). All cases of perforation were cured with conservative treatment. In the SR group, postoperative adverse events such as stricture and leakage occurred in 7 patients (1.7%) with a tumor located in the antrum (4/7, 57.1%) or cardia (3/7, 42.9%). After matching, the overall mean follow-up period was 47.9 ± 37.8 months in the ER group and 41.3 ± 22.6 months in the SR group. No recurrence or distant metastasis occurred in either group during the follow-up period.
ER is an effective and safe therapeutic method that might be comparable with SR for treating small-sized (≤5 cm) gastric GISTs. Selecting the resection method according to the tumor location seems appropriate.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2019.10.020</identifier><identifier>PMID: 31655046</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Case-Control Studies ; Female ; Gastrectomy - methods ; Gastrointestinal Stromal Tumors - surgery ; Gastroscopy ; Humans ; Laparoscopy ; Male ; Middle Aged ; Propensity Score ; Retrospective Studies ; Stomach Neoplasms - surgery ; Treatment Outcome</subject><ispartof>Gastrointestinal endoscopy, 2020-03, Vol.91 (3), p.527-536</ispartof><rights>2020 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-7c69d1549c52e83ec750aabdf764869aa326302f0d05d8ce7ce68b36eb8eaffe3</citedby><cites>FETCH-LOGICAL-c353t-7c69d1549c52e83ec750aabdf764869aa326302f0d05d8ce7ce68b36eb8eaffe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016510719323892$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31655046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Ga Hee</creatorcontrib><creatorcontrib>Choi, Kee Don</creatorcontrib><creatorcontrib>Gong, Chung Sik</creatorcontrib><creatorcontrib>Lee, In-Seob</creatorcontrib><creatorcontrib>Park, Young Soo</creatorcontrib><creatorcontrib>Han, Minkyu</creatorcontrib><creatorcontrib>Na, Hee Kyong</creatorcontrib><creatorcontrib>Ahn, Ji Yong</creatorcontrib><creatorcontrib>Lee, Jeong Hoon</creatorcontrib><creatorcontrib>Jung, Kee Wook</creatorcontrib><creatorcontrib>Kim, Do Hoon</creatorcontrib><creatorcontrib>Song, Ho June</creatorcontrib><creatorcontrib>Lee, Gin Hyug</creatorcontrib><creatorcontrib>Jung, Hwoon-Yong</creatorcontrib><title>Comparison of the treatment outcomes of endoscopic and surgical resection of GI stromal tumors in the stomach: a propensity score–matched case-control study</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>We aimed to investigate the safety and efficacy of endoscopic resection (ER) compared with surgical resection (SR) of gastric GI stromal tumors (GISTs).
This study included 51 and 403 patients who underwent ER and SR, respectively, for ≤5 cm GISTs in the stomach between June 2005 and August 2017. After propensity score matching (1:1) using age, sex, tumor size, mitotic count, and comorbidities, the oncologic outcomes were compared with 48 patients each from ER and SR groups.
The ER group had significantly shorter hospital stay (4.4 ± 2.9 vs 6.6 ± 3.6 days, P < .001) and procedure time (38.3 ± 24.2 vs 66 ± 33.3 min, P < .001). The R0 resection rate was 62.7% in the ER group and 98.5% in the SR group. In the ER group, macroperforation occurred in 6 patients (11.8%) with a tumor located in the fundus (4/6, 66.7%) or body (2/6, 33.3%). All cases of perforation were cured with conservative treatment. In the SR group, postoperative adverse events such as stricture and leakage occurred in 7 patients (1.7%) with a tumor located in the antrum (4/7, 57.1%) or cardia (3/7, 42.9%). After matching, the overall mean follow-up period was 47.9 ± 37.8 months in the ER group and 41.3 ± 22.6 months in the SR group. No recurrence or distant metastasis occurred in either group during the follow-up period.
ER is an effective and safe therapeutic method that might be comparable with SR for treating small-sized (≤5 cm) gastric GISTs. Selecting the resection method according to the tumor location seems appropriate.</description><subject>Aged</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastrointestinal Stromal Tumors - surgery</subject><subject>Gastroscopy</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - surgery</subject><subject>Treatment Outcome</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAURS0EotPCB7BBXrLJYMeJncAKjaCtVIkNrC3P80vHoyQe_Byk2fUf2PNxfAkeprBkZfm-e4_sdxl7JcVaCqnf7tf3Ade1kH25r0UtnrCVFL2ptDH9U7YSxVS1UpgLdkm0F0J0tZLP2YWSum1Fo1fs5yZOB5cCxZnHgecd8pzQ5QnnzOOSIU5IpwnOPhLEQwDuZs9pSfcB3MgTEkIO5_j1Laec4lT0vEwxEQ_zHyblIsLuHXf8kOIBZwr5yAsv4a-HH5PLsEPPwRFWEOeCGEtk8ccX7NngRsKXj-cV-_rp45fNTXX3-fp28-GuAtWqXBnQvZdt00NbY6cQTCuc2_rB6KbTvXOq1krUg_Ci9R2gAdTdVmncduiGAdUVe3Pmltd9W5CynQIBjqObMS5kayX6xmhpmmKVZyukSJRwsIcUJpeOVgp7qsXubanFnmo5SaWWknn9iF-2E_p_ib89FMP7swHLJ78HTJYg4AzoQyrrtT6G_-B_A72xor0</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Kim, Ga Hee</creator><creator>Choi, Kee Don</creator><creator>Gong, Chung Sik</creator><creator>Lee, In-Seob</creator><creator>Park, Young Soo</creator><creator>Han, Minkyu</creator><creator>Na, Hee Kyong</creator><creator>Ahn, Ji Yong</creator><creator>Lee, Jeong Hoon</creator><creator>Jung, Kee Wook</creator><creator>Kim, Do Hoon</creator><creator>Song, Ho June</creator><creator>Lee, Gin Hyug</creator><creator>Jung, Hwoon-Yong</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Comparison of the treatment outcomes of endoscopic and surgical resection of GI stromal tumors in the stomach: a propensity score–matched case-control study</title><author>Kim, Ga Hee ; Choi, Kee Don ; Gong, Chung Sik ; Lee, In-Seob ; Park, Young Soo ; Han, Minkyu ; Na, Hee Kyong ; Ahn, Ji Yong ; Lee, Jeong Hoon ; Jung, Kee Wook ; Kim, Do Hoon ; Song, Ho June ; Lee, Gin Hyug ; Jung, Hwoon-Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-7c69d1549c52e83ec750aabdf764869aa326302f0d05d8ce7ce68b36eb8eaffe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>Gastrointestinal Stromal Tumors - surgery</topic><topic>Gastroscopy</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Ga Hee</creatorcontrib><creatorcontrib>Choi, Kee Don</creatorcontrib><creatorcontrib>Gong, Chung Sik</creatorcontrib><creatorcontrib>Lee, In-Seob</creatorcontrib><creatorcontrib>Park, Young Soo</creatorcontrib><creatorcontrib>Han, Minkyu</creatorcontrib><creatorcontrib>Na, Hee Kyong</creatorcontrib><creatorcontrib>Ahn, Ji Yong</creatorcontrib><creatorcontrib>Lee, Jeong Hoon</creatorcontrib><creatorcontrib>Jung, Kee Wook</creatorcontrib><creatorcontrib>Kim, Do Hoon</creatorcontrib><creatorcontrib>Song, Ho June</creatorcontrib><creatorcontrib>Lee, Gin Hyug</creatorcontrib><creatorcontrib>Jung, Hwoon-Yong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Ga Hee</au><au>Choi, Kee Don</au><au>Gong, Chung Sik</au><au>Lee, In-Seob</au><au>Park, Young Soo</au><au>Han, Minkyu</au><au>Na, Hee Kyong</au><au>Ahn, Ji Yong</au><au>Lee, Jeong Hoon</au><au>Jung, Kee Wook</au><au>Kim, Do Hoon</au><au>Song, Ho June</au><au>Lee, Gin Hyug</au><au>Jung, Hwoon-Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the treatment outcomes of endoscopic and surgical resection of GI stromal tumors in the stomach: a propensity score–matched case-control study</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2020-03</date><risdate>2020</risdate><volume>91</volume><issue>3</issue><spage>527</spage><epage>536</epage><pages>527-536</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>We aimed to investigate the safety and efficacy of endoscopic resection (ER) compared with surgical resection (SR) of gastric GI stromal tumors (GISTs).
This study included 51 and 403 patients who underwent ER and SR, respectively, for ≤5 cm GISTs in the stomach between June 2005 and August 2017. After propensity score matching (1:1) using age, sex, tumor size, mitotic count, and comorbidities, the oncologic outcomes were compared with 48 patients each from ER and SR groups.
The ER group had significantly shorter hospital stay (4.4 ± 2.9 vs 6.6 ± 3.6 days, P < .001) and procedure time (38.3 ± 24.2 vs 66 ± 33.3 min, P < .001). The R0 resection rate was 62.7% in the ER group and 98.5% in the SR group. In the ER group, macroperforation occurred in 6 patients (11.8%) with a tumor located in the fundus (4/6, 66.7%) or body (2/6, 33.3%). All cases of perforation were cured with conservative treatment. In the SR group, postoperative adverse events such as stricture and leakage occurred in 7 patients (1.7%) with a tumor located in the antrum (4/7, 57.1%) or cardia (3/7, 42.9%). After matching, the overall mean follow-up period was 47.9 ± 37.8 months in the ER group and 41.3 ± 22.6 months in the SR group. No recurrence or distant metastasis occurred in either group during the follow-up period.
ER is an effective and safe therapeutic method that might be comparable with SR for treating small-sized (≤5 cm) gastric GISTs. Selecting the resection method according to the tumor location seems appropriate.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31655046</pmid><doi>10.1016/j.gie.2019.10.020</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Case-Control Studies Female Gastrectomy - methods Gastrointestinal Stromal Tumors - surgery Gastroscopy Humans Laparoscopy Male Middle Aged Propensity Score Retrospective Studies Stomach Neoplasms - surgery Treatment Outcome |
| title | Comparison of the treatment outcomes of endoscopic and surgical resection of GI stromal tumors in the stomach: a propensity score–matched case-control study |
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