Role of surgical resection for patients with recurrent or metastatic gastrointestinal stromal tumors: A systematic review and meta-analysis

INTERNATIONAL JOURNAL OF SURGERY

卷:56

Review

Cai, Zhaolun¹  Yin, Yuan¹  Shen, Chaoyong¹  Tang, Sumin¹  Yin, Xiaonan¹  Chen, Zhixin¹  Zhang, Bo¹ 

[1] Sichuan Univ, West China Hosp, Dept Gastrointestinal Surg, Chengdu 610041, Sichuan, Peoples R China

关键词: Gastrointestinal stromal tumors;    GISTs;    Surgery;    Metastatic;    Recurrent;   

DOI  :  10.1016/j.ijsu.2018.06.016

来源: Elsevier

【 摘 要 】

Background: The role of surgical resection for patients with recurrent or metastatic gastrointestinal stromal tumors is still controversial. This meta-analysis aims to investigate the clinical outcomes of surgery combined with tyrosine kinase inhibitors among patients with recurrent or metastatic gastrointestinal stromal tumors. Methods: We systematically searched PubMed, EMBASE, the Cochrane Library and Wanfangdata without language restriction. Random effect models were used to estimate pooled hazard ratio and the corresponding 95% confidence intervals. Subgroup analyses, sensitivity analysis and trim and fill analysis were also performed. Results: A total of 1416 patient from 9 studies were finally enrolled in this meta-analysis. The summary results showed that surgery combined with tyrosine kinase inhibitors showed a tendency of a longer overall survival compared with tyrosine kinase inhibitors treatment alone (HR by random-effects model 0.68, 95% CI 0.54-0.85, I-2=44.7%) and improved progress-free survival (HR by random-effects model 0.50,95% CI, 0.33-0.76, I-2=17.9%). The trim and fill analysis and sensitive analysis indicated the relatively robust result. Conclusion: Surgery combined with tyrosine kinase inhibitors therapy is associated with a better overall survival and progression free survival for patients with recurrent or metastatic gastrointestinal stromal tumors as compared with TKIs treatment alone.

【 授权许可】

Free