Researchers Suggests Revising Follow-Up for Low-Risk GIST Patients to Balance Early Detection and Risks

In a cohort study, researchers analyzed the outcomes of guideline-based follow-up in patients with low-risk gastrointestinal stromal tumors (GISTs). The study included 737 patients who underwent surgical resection for low-risk GIST, with a median follow-up of 69.2 months. The results showed that 42 patients (5.7%) experienced relapse, translating to one relapse detected for every 170 computed tomography scans. Additionally, secondary tumors impacted 25% of the patients and were the leading cause of death in this group, suggesting that relapses in low-risk GISTs are rare but can occur even after more than 10 years.

The researchers highlighted the need to reassess current follow-up schedules for low-risk GIST to reduce the psychological burden, costs, and radiation exposure from frequent imaging tests. The prevalence of secondary tumors in this patient population also underscores the importance of regular screening and monitoring for other malignancies during follow-up visits. The findings call for a more tailored approach to surveillance, balancing the need for early relapse detection against the risks and costs associated with intensive follow-up protocols.

Reference: D’Ambrosio L, Fumagalli E, De Pas TM. Guideline-Based Follow-Up Outcomes in Patients With Gastrointestinal Stromal Tumor With Low Risk of Recurrence: A Report From the Italian Sarcoma Group. JAMA Netw Open. 2023 Nov 1;6(11):e2341522. doi: 10.1001/jamanetworkopen.2023.41522. Erratum in: JAMA Netw Open. 2024 Jan 2;7(1):e2354891.

Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811395