What question did this study set out to answer?

To evaluate the impact of adjuvant therapy on overall survival in patients with localized GIST classified as high-risk.

May 29, 2026Journal of Clinical Oncology0 citations

Benefit of adjuvant therapy in high-risk GIST: A large-scale real-world analysis of 2,166 patients (DEEPSARC study).

NPNicolas Penel VTV. Thevenet NHNoémie Huchet

Key Points

To evaluate the impact of adjuvant therapy on overall survival in patients with localized GIST classified as high-risk.
Conducted a retrospective analysis merging data from NETSARC+ and national social security health data.
Included 2166 GIST patients treated between January 2012 and December 2017.
Analyzed the association between adjuvant therapy and overall survival using univariate and multivariate methods.
5-year overall survival rate for high-risk patients receiving adjuvant therapy was 82% compared to 81% for those not receiving it.
Adjuvant therapy significantly improved overall survival for high-risk patients with Miettinen/AFIP classification (HR 0.23, 95% CI 0.06-0.92, P=0.017).
No significant survival benefit was observed in intermediate-risk patients.

Abstract

11533 Background: Real-life data on the impact of adjuvant treatment in GIST pts are limited. Methods: We conducted a retrospective study (Deepsarc) merging data from the NETSARC+ dataset of the French Sarcoma Group with the exhaustive health data from the national social security system (SNDS). Eligible pts were treated between January 1, 2012, and December 31, 2017 with localized GIST. The relation between overall survival (OS) and adjuvant therapy was studied univariate and multivariate, using different methods to address confounding factors. Results: A total of 2166 GIST pts were included, with a median age of 68.0 years (interquartile range (IQR): 58.0, 76.0), a sex ratio of 1.01. The two most common primary sites were gastric (1301, 60%) and small intestine (527, 24%). Median tumor size at diagnosis was 5.3 cm (IQR 3.6-8.1). Median mitotic count was 3.0 (IQR 1.0-5.0). According to Miettinen/AFIP classification, 331/1026 (32%) were high-risk, 192/1026 (19%) intermediate risk, and 503/1026 (49%) very low or low risk vs 490/912 (53%) high-risk, 193/912 (21%) intermediate risk, and 229/912 (25%) very low or low risk with Joensuu classification. From 2012 to 2017, the proportion of pts receiving adjuvant therapy remained remarkably stable at around one third of all GIST, with higher use in high-risk (70%; 231/331) than intermediate-risk (43%; 83/192) and low-risk pts (6%; 32/503). Pts receiving adjuvant therapy were younger (p10 cm) highlights a benefit of adjuvant therapy for high-risk pts, according to both AFIP/Miettinen or Joensuu classifications (Table). No clear benefit was observed in intermediate-risk pts. Conclusion: This study confirms the benefit of adjuvant therapy for high-risk pts (according to AFIP/Miettinen or Joensuu), but not for other risk groups. Overall survival (risk of death) in high-risk GIST patients according to adjuvant therapy (reference = No adjuvant treatment), Deepsarc study (2012-2017), France. Risk classification N 1y HR* 95% CI** P -value Miettinen/AFIP 214 0.23 0.06 ; 0.92 0.017 Joensuu 312 0.49 0.24 ; 0.98 0.029 *HR = Hazard Ratio, **CI = Confidence Interval.

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