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Session: ePoster: Other Neoplasia and Endoscopy 2 (Sun1230)

EP454 - Rectal Gastrointestinal Stromal Tumors: Is Surgery necessary for Survival? A SEER Database analysis

Sunday, May 11, 2025
1:08 PM – 1:13 PM PT
Location: Monitor 7, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Karri E. Hester, MD, MS (she/her/hers)

    Resident Surgeon
    Danbury Hospital, Department of Surgery
    Danbury Hospital, Department of General Surgery
    Danbury, CT, United States

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

    • Author(s)

  • DP

    Deep S. Pandya, n/a

    Biomedical and Clinical Data Informatics Research Manager
    Danbury Hospital, Research Department
    Danbury, Connecticut, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • XD

    Xiang Dong, MD, FACS

    Chief of Surgical Oncology
    Danbury Hospital, Department of Surgery
    Danbury, Connecticut, United States

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

All of the relevant financial relationships listed below have been mitigated.
Karri E. Hester, MD, MS: This individual has no financial relationships with ineligible companies.
Xiang Dong, MD, FACS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Gastrointestinal stromal tumors (GISTs) are a mesenchymal tumor commonly found in the GI tract. They are typically found in the stomach and small intestine, and rarely in the colon and rectum. While they only comprise approximately 5% of all GIST tumors, they are known to carry high-risk features with a chance of recurrence and metastatic disease. Surgery continues to be the mainstay of treatment but there is little known regarding its effect on overall survival. Additionally, while chemotherapy and radiation are integral in the treatment of other rectal tumors, their effect on GIST tumors has also not been well-documented.

Methods/Interventions: This study used SEER data (2000–2020) from 17 registries, focusing on rectal GIST cases with malignant behavior and known age. Survival outcomes were analyzed by treatment type, particularly surgery, across age groups. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the impact of surgery on survival.

Results/Outcomes: A total of 386 patients were identified with a GIST tumor of the rectum. Most cases were diagnosed between 2010 and 2020.

Across all age groups, surgery significantly improves survival. However, the highest survival benefit is seen in younger patients (under 60 years). The survival analysis also shows a clear trend of decreasing survival with increasing age. The 25-29 age group has the highest median survival at 120.5 months, while the 85+ group has the lowest at 24.67 months. A significant decline in survival is observed after age 65, indicating that younger patients generally have better outcomes compared to older individuals.

Survival analysis using Kaplan-Meier and Cox proportional hazards models revealed that surgery significantly improved survival outcomes in rectal GIST patients. The median survival for the surgery group was 152.28 months compared to 98.31 months for the non-surgery group (Log-Rank test p = 0.0005). Multivariate analysis with Cox regression showed that surgery reduced the risk of death by 40% (HR = 0.598, 95% CI: 0.36–0.99, p = 0.0483). Age was also a significant predictor, with older patients showing higher mortality risk (p < 0.0001). Other factors, such as time to treatment, sex, external beam radiation, and chemotherapy, were not statistically significant.

Conclusion/Discussion: Surgical intervention for rectal GISTs results in improved survival. Intervention at younger ages has the highest survival benefit, but surgery at any age is associated with positive outcomes. There was no survival benefit in chemotherapy and radiation for the treatment of Rectal GISTs. These findings underscore the importance of early surgical intervention in managing rectal GISTs and provide valuable insights for optimizing treatment strategies.