Treatment options for giant gastrointestinal stromal tumours and related prognosis: a single-centre retrospective study.

Abstract

Controversy persists about the best treatment for giant gastrointestinal stromal tumours (GISTs). This retrospective study aimed to investigate the different treatments for giant GISTs and the effect on outcomes. A total of 71 patients with GIST ≥10 cm in diameter were separated into four groups according to treatment received: emergency surgery group (n = 17), preoperative targeted (imatinib) therapy group (n = 12), palliative resection group (n = 17) and R0 resection group (n = 25). Baseline, intraoperative and post-operative findings were compared between the groups. Long-term follow-up was conducted to assess outcomes. Preoperative gastrointestinal bleeding was significantly higher (P = 0.003) and haemoglobin level was significantly lower (P < 0.05) in the emergency surgery group than in the other groups. Mean tumour diameter was significantly more in the palliative resection group than in the other groups (P = 0.023). Overall survival was significantly higher in the R0 resection group and the preoperative targeted therapy group than in the other two groups (P < 0.05). In patients with giant GISTs, the best outcomes appear to be achieved with preoperative imatinib therapy plus surgery or R0 resection followed by imatinib therapy.