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ORIGINAL RESEARCH article

Front. Surg.

Sec. Surgical Oncology

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1569677

Survival Outcome and Impact of Delayed Imatinib Therapy in Gastric Gastrointestinal Stromal Tumors

Provisionally accepted
Raynuka Jansuwan Raynuka Jansuwan Srila Samphao Srila Samphao Wongsakorn Chaochankit Wongsakorn Chaochankit *
  • Prince of Songkla University, Songkhla, Thailand

The final, formatted version of the article will be published soon.

    Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the stomach being the predominant site. Surgical resection is the primary treatment for localized disease, but recurrence remains a concern, particularly in high-risk patients. Tyrosine kinase inhibitors (TKIs), such as imatinib, improve disease-free survival (DFS), yet their accessibility is often limited in resource-constrained settings. Methods: This retrospective cohort study included gastric GIST patients who underwent surgical resection between 2015 and 2020 at a tertiary referral center. DFS and overall survival (OS) were analyzed using Kaplan-Meier curves and Cox proportional hazards regression. Results: A total of 86 patients were included, with 40 (46%) classified as high-risk. The 5-year DFS was significantly lower in high-risk patients (40% vs. 95.7%, p < 0.001). Imatinib therapy group was associated with worse DFS in high-risk patients (p = 0.003), likely due to delayed initiation after recurrence rather than adjuvant use. Significant predictors of poor DFS included smoking (p < 0.001), prolonged operative time (p = 0.034), and advanced tumor stage (p < 0.001). Conclusion: Delayed imatinib therapy negatively impacts DFS in high-risk gastric GIST patients, highlighting the need for improved access to early TKI treatment. Additionally, smoking cessation and optimized perioperative management may enhance survival outcomes. Addressing modifiable risk factors and ensuring timely posoperative treatment could improve prognosis in this population.

    Keywords: Gastrointestinal Stromal Tumor, Gastric GIST, Disease-Free Survival, Imatinib therapy, Delayed treatment, prognostic factors

    Received: 01 Feb 2025; Accepted: 24 Mar 2025.

    Copyright: © 2025 Jansuwan, Samphao and Chaochankit. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wongsakorn Chaochankit, Prince of Songkla University, Songkhla, Thailand

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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