Endoscopic, Surgical Treatment Provides Similar OS, CSS Results for GISTs

While endoscopic treatment for small gastrointestinal stromal tumors (GISTs) is common, it has not been recognized by national guidelines for tumors larger than 5 cm due to safety concerns and possible adverse outcomes.

A study led by Zide Liu, MD, and colleagues compared the long-term survival outcomes of endoscopic and surgical treatment for GISTs ranging from 5 to 10 cm.

A total of 1223 patients with GISTs were selected from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Long-term survival outcomes were compared using Kaplan-Meier analysis and log-rank tests, and a multivariate Cox proportional hazards model was used to identify potential risk factors that could influence prognosis.

A total of 144 (11.8%) patients received endoscopic treatment, while 1079 (88.2%) received surgical treatment. Before using 1:1 propensity score matching (PSM) to balance baseline data, no significant difference was noted in the long-term survival rates between patient groups (5-year overall survival [OS], 86.5% vs 83.5%; P=.42; 10-year OS, 70.4% vs 66.7%; P=.42).

After adjusting for covariates, the OS (hazard ratio [HR], 1.26; 95% CI, 0.89-1.77; P=.19) and cancer-specific survival (CSS; HR, 1.69; 95% CI, 0.99-2.89; P=.053) risks were similar.

In analysis after PSM, no significant difference was noted between the treatment groups. Long-term OS and CSS were similar for endoscopic and surgical treatment in patients with GISTs between 5 and 10 cm.