Safety and efficacy of endoscopic resection for gastric gastrointestinal stromal tumors: a retrospective cohort study.

IF 1.7 4区医学 Q2 SURGERY Minimally Invasive Therapy & Allied Technologies Pub Date : 2025-01-10 DOI:10.1080/13645706.2024.2449266

Xiaodan Zhao, Yadong Feng, Mingyue Li, Ye Zhu, Xiajiao Tang, Ruihua Shi

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Abstract

Background: The aim of this study was to verify the safety and efficacy of endoscopic resection (ER) for gastric gastrointestinal stromal tumors (GISTs).

Methods: Among a consecutive series of resections for gastric GISTs performed in a single center, the outcomes of patients who had ER were compared to standard surgical resection (SR).

Results: In the cohort, 329 consecutive primary localized gastric GISTs patients (n, ER/SR = 251/78) were enrolled. Patients receiving ER were revealed to have preferable post-treatment outcomes, prolonged overall survival (OS) and disease-free survival (DFS). Tumor diameter, the only independent risk factor for a complicated post-operative course, was utilized for propensity score matching (PSM). In the PSM cohort, patients receiving ER and SR with similar tumor size (4.0 [2.7-4.5] cm) shared similar aggressiveness in terms of stomach layers of tumor origination and invasion, and modified National Institutes of Health (mNIH) risk criteria. Shorter operative time, fewer economic costs, and shorter post-operative stay were still observed in the ER group (ER vs. SR: 80 [49-120] vs. 120 [98-160] minutes, p < 0.001; 44 [38-51] vs. 60 [49-84] thousand Renminbi [kRMB], p < 0.001; 7.0 [6.0-8.0] vs. 8.5 [6.0-12] days, p = 0.018, respectively). No significant difference in OS and DFS was demonstrated in the PSM cohort.

Conclusions: ER is safe and effective, thus a feasible treatment option for indicated gastric GISTs patients with the advantage of faster recovery and lower economic costs.

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内镜下胃肠道间质瘤切除术的安全性和有效性：一项回顾性队列研究。

背景：本研究的目的是验证内镜下切除（ER）治疗胃肠道间质瘤（gist）的安全性和有效性。方法：在单一中心进行的连续一系列胃胃肠道间质瘤切除术中，将ER患者的结果与标准手术切除（SR）进行比较。结果：在队列中，329例连续的原发性局部胃gist患者（n, ER/SR = 251/78）被纳入。接受ER治疗的患者具有较好的治疗后预后，延长了总生存期（OS）和无病生存期（DFS）。肿瘤直径是术后复杂病程的唯一独立危险因素，用于倾向评分匹配（PSM）。在PSM队列中，接受ER和SR治疗的肿瘤大小相似（4.0 [2.7-4.5]cm）的患者在肿瘤起源和侵袭的胃层方面具有相似的侵袭性，并修改了美国国立卫生研究院（mNIH）的风险标准。ER组手术时间更短，经济成本更低，术后住院时间更短（ER与SR: 80 [49-120] vs. 120 [98-160] min, p p p = 0.018）。在PSM队列中，OS和DFS没有显着差异。结论：内窥镜治疗安全有效，具有恢复快、经济成本低的优势，是适应期胃间质瘤患者可行的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.