Radical Versus Non-Radical Resection for Small intestinal Gastrointestinal Stromal Tumors: A Propensity Score-Matched Analysis

Abstract Surgical resection is the first choice for the treatment of small intestinal gastrointestinal stromal tumors (GISTs), but the best surgical method for small intestinal stromal tumors remains undefined. It is not clear whether there is a difference in the long-term survival of small intestinal GISTs between radical surgery and non-radical surgery. We included 877 patients with small intestinal stromal tumors who underwent surgery between 2010 and 2015 from the SEER database. They were divided into the radical resection group and the non-radical resection group. To minimized the selection bias and mixed bias in the comparison, propensity score matching (PSM) and multivariate regression analysis were carried out. In the entire cohort, 120 patients underwent radical surgery and 757 patients received non-radical resection. The 1, 3, and 5-year OS rates were 95.7%, 80.2%, and 69.6% in the radical resection group versus 94.3%, 86.8%, and 77.2% in the non-radical resection group, respectively. (p=0.069) Meanwhile, radical resection had the similar CSS rates of 1, 3 and 5-year compared with non-radical surgery. (1-year CSS rate: 97.4% vs. 98.0%, 3-year CSS rate: 86.1% vs. 93.2%, 5-year CSS rate: 81.6% vs. 88.3%; p =0.056) Besides, after adjusting for other clinical factors and PSM, the long-term OS and CSS did not significantly differ between radical surgery and non-radical surgery. Our study preliminarily found that for small intestinal GISTs, there was no significant difference in long-term survival between radical surgery and non-radical surgery.