Salvage surgery for patients with recurrent gastrointestinal sarcoma. Prognostic factors to guide-patient selection Journal Article
| Authors: | Mudan, S. S.; Conlon, K. C.; Woodruff, J. M.; Lewis, J. J.; Brennan, M. F. |
| Article Title: | Salvage surgery for patients with recurrent gastrointestinal sarcoma. Prognostic factors to guide-patient selection |
| Abstract: | BACKGROUND. Gastrointestinal sarcomas are rare stromal tumors and most are classifiable as malignant gastrointestinal stromal tumors. They have a high propensity for intraabdominal recurrence. It is unclear whether there is a survival advantage from reoperation for recurrent disease or if surgery should be confined to symptom relief. The authors have attempted to identify features that may allow the selection of patients most likely to benefit from reoperation. METHODS. Retrospective univariate and multivariate analyses of 60 patients with recurrent gastrointestinal sarcoma, accrued from a prospective data base between July 1982 and September 1995, were performed. RESULTS. Initial recurrence was evident by a median of 20 months from primary resection. Most patients (85%) had an initial symptomatic recurrence. Local recurrence was seen in 76% of patients, but in half of these synchronous hepatic metastases were present. None had disease outside of the abdomen. Complete resection of recurrent disease was possible in only one-third of cases. Median survival after surgery for recurrence was 15 months, but was longest for patients whose recurrence took the form of liver metastases in the absence of disease elsewhere. In multivariate analysis of postrecurrence survival, the only significant determinant of survival was the length of the disease free interval between the initial operation and recurrence. CONCLUSIONS. Survival following recurrence of a gastrointestinal sarcoma is largely determined by the tumor biology, one manifestation of which is the disease free interval. Except for patients with a long disease free interval, surgery should be reserved largely for symptom control. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; survival analysis; cancer surgery; treatment failure; retrospective studies; major clinical study; clinical feature; salvage therapy; patient selection; recurrent cancer; cancer palliative therapy; treatment indication; neoplasm recurrence, local; proportional hazards models; digestive system cancer; sarcoma; gastrointestinal neoplasms; liver metastasis; reoperation; surgery; analysis of variance; recurrent; gastrointestinal; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Cancer |
| Volume: | 88 |
| Issue: | 1 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2000-01-01 |
| Start Page: | 66 |
| End Page: | 74 |
| Language: | English |
| DOI: | 10.1002/(sici)1097-0142(20000101)88:1<66::aid-cncr10>3.0.co;2-0 |
| PUBMED: | 10618607 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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