Quality of surgery and surgical reporting for patients with primary gastrointestinal stromal tumours participating in the EORTC STBSG 62024 adjuvant imatinib study
| Autor: | Paolo G. Casali, Frits van Coevorden, Eberhard Stoeckle, Saskia Litière, Alessandro Gronchi, Eva Wardelmann, Sylvie Bonvalot, Peter Hohenberger, Pjotr Rutkowski, Christine Olungu |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Gastrointestinal Stromal Tumors medicine.medical_treatment Antineoplastic Agents 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Laparoscopy Digestive System Surgical Procedures Gastrointestinal Neoplasms Quality of Health Care medicine.diagnostic_test GiST business.industry Incidence (epidemiology) Postoperative complication Cancer Prognosis medicine.disease Combined Modality Therapy Endoscopy Surgery Survival Rate 030104 developmental biology Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Imatinib Mesylate Quality of Life Lymphadenectomy Neoplasm Recurrence Local Segmental resection business Follow-Up Studies |
| Zdroj: | European Journal of Cancer. 120:47-53 |
| ISSN: | 0959-8049 |
| Popis: | Background EORTC (European Organisation of Research and Treatment of Cancer) 62024 is a phase III randomised trial evaluating adjuvant imatinib in patients with gastrointestinal stromal tumours (GISTs) and no evidence of residual disease after surgery in 908 patients from 11 countries participated. As surgical treatment aspects (tumour rupture and incomplete resection) contribute to the risk of recurrence, the data of primary surgery were reviewed. Methods The surgical record, local pathology report and a surgical questionnaire on details of the operation had to be completed when patients entered the study. Surgeons from 5 countries, covering 8 languages, reviewed the full set of data being available from 793 patients (87.3%). Results A known GIST was the reason for surgery in only 58% of the cases, and 12% of the patients were treated as an emergency. The R0-resection rate was 87%. The extent of resection was local excision in 17%, segmental resection in 59%, full-organ resection in 11% and multivisceral resection in 11%, with lymphadenectomy performed in 24% of the patients. Shelling out of the tumour was performed in 9.7%, and the proportion of tumours removed in parts was higher in the endoscopy/laparoscopy group. The incidence of tumour rupture (representing M1) was 9%. The consistency between preoperative and intraoperative findings was 82%. The postoperative complication rate was 7.3%. Conclusion The standardisation of surgery in this study was inferior. Given the review data, 18% of the patients should not have participated in the trial. Quality of surgery and improperly reported intraoperative details might influence the trial results. A detailed surgical questionnaire filled out by the surgeon is mandatory before entering the patient in an adjuvant trial in GIST. |
| Databáze: | OpenAIRE |
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