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Peer-reviewedCC BY-NC-NDBMC gastroenterology

Recurrence‑related factors after discontinuation of adjuvant imatinib in intermediate‑ and high‑risk GIST: a retrospective cohort study.

  • Yibo Huang1
  • Xiaolong Zheng1
  • Lin Gao1
  • Lianlian Cao2
  • Zhaoping Li2
  • Hao Chen1
  • Li Chen1
  • Liang Tao1
  • Meng Wang3,4
  • Tingting Tao5,6
  • Wenxian Guan7,8
  • Feng Wang9,10
10 affiliations
  1. 1Department of Gastric Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China.
  2. 2Department of Gastric Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, China.
  3. 3Department of Gastric Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China. [email protected].
  4. 4Department of Gastric Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, China. [email protected].
  5. 5Department of Gastric Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China. [email protected].
  6. 6Department of Gastric Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, China. [email protected].
  7. 7Department of Gastric Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China. [email protected].
  8. 8Department of Gastric Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, China. [email protected].
  9. 9Department of Gastric Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China. [email protected].
  10. 10Department of Gastric Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, China. [email protected].
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Abstract

Background

Gastrointestinal stromal tumors (GIST) are rare malignancies originating from mesenchymal tissue, with imatinib as the standard postoperative adjuvant therapy, especially for high-risk patients. However, recurrence after discontinuation remains an important clinical problem. This study aimed to identify factors influencing recurrence after imatinib discontinuation in intermediate- and high-risk GIST patients to guide individualized treatment strategies.Methods

Patients who underwent surgical resection and imatinib adjuvant therapy in Nanjing Drum Tower Hospital from 2011 to 2021 were retrospectively analyzed. In this study, end-point of tumor treatment ( EOOT ) recurrence-free survival ( RFS ) was used as the primary endpoint, which was defined as the time from the end of imatinib adjuvant therapy to the recurrence or metastasis of GIST. Univariate and multivariate Cox regression analyses, along with Kaplan-Meier curves, were used to assess the impact of clinicopathological factors.Results

Among 82 patients who discontinued imatinib, 19 experienced recurrence. Tumor site, tumor size, mitotic index, Ki-67 index, risk classification, and mutation type were significantly associated with recurrence (P < 0.05). Kaplan-Meier analysis showed that non-gastric tumors, larger size, high Ki-67, and mitotic index were linked to poorer EOOT RFS. In addition, while the EOOT RFS of patients who had been on the drug for more than 3 years was not statistically significantly different from those who had been on the drug for a shorter period of time, overall the RFS after discontinuation was longer in patients who had been on the drug for a longer period of time.Conclusion

Tumor size, mitotic index, Ki-67 index, and mutation type are key factors influencing recurrence after imatinib discontinuation. Prolonging the time of adjuvant therapy has an important prognostic improvement effect on high-risk patients.

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Cite

BibTeXRIS
BibTeX
@article{huang2026recurrencerelated,
  title = {{Recurrence‑related factors after discontinuation of adjuvant imatinib in intermediate‑ and high‑risk GIST: a retrospective cohort study.}},
  author = {Yibo Huang and Xiaolong Zheng and Lin Gao and Lianlian Cao and Zhaoping Li and Hao Chen and Li Chen and Liang Tao and Meng Wang and Tingting Tao and Wenxian Guan and Feng Wang},
  journal = {BMC gastroenterology},
  year = {2026},
  month = jul,
  doi = {10.1186/s12876-026-05150-4},
  url = {https://europepmc.org/article/MED/42907768},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Recurrence‑related factors after discontinuation of adjuvant imatinib in intermediate‑ and high‑risk GIST: a retrospective cohort study.
AU  - Yibo Huang
AU  - Xiaolong Zheng
AU  - Lin Gao
AU  - Lianlian Cao
AU  - Zhaoping Li
AU  - Hao Chen
AU  - Li Chen
AU  - Liang Tao
AU  - Meng Wang
AU  - Tingting Tao
AU  - Wenxian Guan
AU  - Feng Wang
PY  - 2026
DA  - 2026/07/01
JO  - BMC gastroenterology
DO  - 10.1186/s12876-026-05150-4
UR  - https://europepmc.org/article/MED/42907768
AB  - Background  Gastrointestinal stromal tumors (GIST) are rare malignancies originating from mesenchymal tissue, with imatinib as the standard postoperative adjuvant therapy, especially for high-risk patients. However, recurrence after discontinuation remains an important clinical problem. This study aimed to identify factors influencing recurrence after imatinib discontinuation in intermediate- and high-risk GIST patients to guide individualized treatment strategies.Methods  Patients who underwent surgical resection and imatinib adjuvant therapy in Nanjing Drum Tower Hospital from 2011 to 2021 were retrospectively analyzed. In this study, end-point of tumor treatment ( EOOT ) recurrence-free survival ( RFS ) was used as the primary endpoint, which was defined as the time from the end of imatinib adjuvant therapy to the recurrence or metastasis of GIST. Univariate and multivariate Cox regression analyses, along with Kaplan-Meier curves, were used to assess the impact of clinicopathological factors.Results  Among 82 patients who discontinued imatinib, 19 experienced recurrence. Tumor site, tumor size, mitotic index, Ki-67 index, risk classification, and mutation type were significantly associated with recurrence (P < 0.05). Kaplan-Meier analysis showed that non-gastric tumors, larger size, high Ki-67, and mitotic index were linked to poorer EOOT RFS. In addition, while the EOOT RFS of patients who had been on the drug for more than 3 years was not statistically significantly different from those who had been on the drug for a shorter period of time, overall the RFS after discontinuation was longer in patients who had been on the drug for a longer period of time.Conclusion  Tumor size, mitotic index, Ki-67 index, and mutation type are key factors influencing recurrence after imatinib discontinuation. Prolonging the time of adjuvant therapy has an important prognostic improvement effect on high-risk patients.
SN  - 1471-230X
ER  -