EP449 - Comparative analysis of surgical approaches for rectal gastrointestinal stromal tumor (GIST) with neoadjuvant chemotherapy

Sunday, May 11, 2025

12:40 PM – 12:45 PM PT

Location: Monitor 7, Sails Pavilion, Upper Level

ePoster Presenter(s)

Byeo Lee Lim, MD, PhD

Clinical assistant professor
Soonchunhyang university hospital, Seoul
SEOUL, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

CK

Chan Wook Kim, n/a

Professor
Asan Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

YK

Young Il Kim, n/a

Assistant professor
Department of Surgery, Division of Colon and Rectal Surgery, University of Ulsan College of medicine, Asan Medical Center, Seoul, Republic of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
JL

Jong Lyul Lee, n/a

Associate professor
Asan Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Disclosure information not submitted.
YY

Yong Sik Yoon, n/a

Professor
University of Ulsan College of Medicine and Asan Medical Center
Songpa gu, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
In Ja Park, MD. PhD.

Professor
Asan Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SL

Seok-Byung Lim, n/a

Professor
Department of Surgery, Division of Colon and Rectal Surgery, University of Ulsan College of medicine, Asan Medical Center, Seoul, Republic of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Byeo Lee Lim, MD, PhD: This individual has no financial relationships with ineligible companies.

Chan Wook Kim, n/a: This individual has no financial relationships with ineligible companies.

Young Il Kim, n/a: This individual has no financial relationships with ineligible companies.

Yong Sik Yoon, n/a: This individual has no financial relationships with ineligible companies.

In Ja Park, MD. PhD.: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Gastrointestinal stromal tumors (GISTs) of rectum are rare and appropriate surgical approach for them is still controversial. The aim of this study was to compare the clinicopathologic characteristics and oncologic outcomes of different surgical approaches for the management of rectal GISTs in order to determine the most effetive strategy

Methods/Interventions: Between January 2000 and April 2023, 128 patients who underwent surgical resection for rectal GIST at Asan Medical Center were retrospectively analyzed. The patients were divided into two groups: Total mesorectal excision(TME) and local excision(LE). The oncologic outcomes, including overall survival (OS) and recurrence free survival (RFS), were compared between TME and LE groups.

Results/Outcomes: Of the 128 patients, 43(33.6%) received TME and 85(66.4%) received LE. Patients with tumors>5cm and receiving neoadjuvant CTx were more common in the TME group (P < 0.001, P=0.008, respectively), while patients with tumors < 2cm and proportion of R0 resection rate were higher in LE group (P < 0.001, P=0.022, respectivly). There were no significant differences between the TME and LE groups in terms of 5-year OS and RFS (OS: 92.2% vs. 96.8%, P=0.060; RFS: 82.9% vs. 67.4%, P=0.025). The average of diameter of the tumor decreased significantly in patients who received neodjuvent CTx, sized from 66.5 ± 28.6 (mm) to 49.4 ± 19.7 (mm) (P=0.002).

Conclusion/Discussion: Local excision is a viable treatment option for rectal GIST patients, with a comparable oncologic outcome and improved quality of life, and it can also be considered for large-sized lesions, particularly in the era of neoadjuvant CTx.