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Advances in GIST Management

(P 39) MANAGEMENT PRACTICES OF GASTROINTESTINAL STROMAL TUMORS: A QUESTIONNAIRE SURVEY OF GENERAL SURGEONS IN CHINA

Location: The Liffey, Level 1

    Author(s)

  • peng zhang, MD

    chief physicians
    Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
    wuhan, Hubei, China (People's Republic)

    • Co-Author(s)

  • mw

    ming wang, MD

    Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine
    shanghai, Shanghai, China (People's Republic)

  • tw

    tao wang, MD

    Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
    hubei, Hubei, China (People's Republic)

  • ff

    fan feng, MD

    Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Air Force Medical University
    xi'an, Shanxi, China (People's Republic)

  • md

    maojun di, MM

    Department of Gastrointestinal Surgery, Taihe Hospital，Hubei University of Medicine
    shiyan, Hubei, China (People's Republic)

  • yz

    yan zhao, MD

    Department of Stomach Surgery, Affiliated Cancer Hospital of Dalian Technological University; Liaoning Cancer Hospital and Institute
    shenyang, Liaoning, China (People's Republic)

  • HL

    Han Liang, MD, PhD

    Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer; Tianjin Key Laboratory of Digestive Cancer, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, P. R. China
    Tianjin, Tianjin, China (People's Republic)

  • wj

    weidong jin, MD

    Department of General Surgery, General Hospital of Central Theater Command
    wuhan, Hubei, China (People's Republic)

  • jz

    jun zhang, MD

    Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University
    Chongqing, Chongqing, China (People's Republic)

  • yf

    yang fu, MD

    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University
    Zhengzhou, Henan, China (People's Republic)

  • jc

    jiansi chen, MD

    Department of Medical Image Center, Affiliated Tumor Hospital of Guangxi Medical University
    nanning, Guangxi, China (People's Republic)

  • Jian Li, MD, PhD

    Chief Physician
    Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute Beijing 100142, P. R. China
    Beijing, Beijing, China (People's Republic)

  • Haoran Qian, MD

    Chief physician
    Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
    hangzhou, Zhejiang, China (People's Republic)

  • Xinhua Zhang, MD, PhD

    Associate Professor, Deputy Director
    Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University
    guangzhou, Guangdong, China (People's Republic)

  • ll

    leping li, MD

    Department of Gastrointestinal Surgery，Shandong Provincial Hospital Affiliated to Shandong First Medical University
    jinan, Shandong, China (People's Republic)

  • ks

    kuntang shen, MD

    Department of Gastrointestinal Surgery , Zhongshan Hospital, Fudan University
    shanghai, Shanghai, China (People's Republic)

  • yl

    yong li, MD

    Department of General Surgery，The Fourth Hospital of Hebei Medical University
    shijiazhuan, Hebei, China (People's Republic)

  • yy

    yingjiang ye, MD

    Department of Gastrointestinal Surgery, Peking University People's Hospital
    beijing, Beijing, China (People's Republic)

  • hc

    hui cao, MD

    Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
    shanghai, Shanghai, China (People's Republic)

  • KT

    Kaixiong Tao, MD

    Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
    wuhan, Hubei, China (People's Republic)

Objective: Since Imatinib was approved by the U.S. Food and Drug Administration (FDA) for GIST treatment, the survival period of patients with GIST receiving standardized treatment has been significantly prolonged. GIST are expected to gradually enter the category of "chronic diseases." Therefore, it is necessary to implement a whole-process management for patients with GISTs.To obtain information on the whole-process management concept of GIST among general surgeons in China，we conducted a national questionnaire survey.

Methods: In this survey study, a questionnaire (41 questions) was distributed online between May 1 and June 30, 2021, among the general surgeons to evaluate the status of the whole-process management concept of GIST.

Results: In total, 697 valid questionnaires were completed. Among the survey participants, 64 (9.2%) were residents, 172 (24.7%) were surgeons-in-charge, 235 (33.7%) were associate-chief surgeons, and 226 (32.4%) were chief surgeons. In the past five years, 122 (32.9%), 76 (20.5%), 76 (20.5%), and 97 (26.1%) hospitals had GIST laparoscopic surgery rates of >75%, 50–75%, 25–50%, and ≤ 25%, respectively. In terms of genetic testing, 248 (66.8%) hospitals had KIT/PDGFRA genetic testing capability. Among the surveyed hospitals, 48 (12.9%) had GIST-specialized outpatient clinics and 213 (57.4%) centers regularly conducted multidisciplinary team (MDT) discussions on GIST. Ninety-one (24.5%) hospitals established a GIST database and 93 (25.1%) hospitals regularly held GIST patient education lectures. Three hundred and nine (83.3%) hospitals regularly followed-up with patients with GISTs. Univariate analysis showed that tertiary hospitals and hospitals with an annual number of GIST operations of >50 cases had better GIST whole-process management concepts than other hospitals, while western hospitals had poorer GIST whole-process management concepts (P < 0.05).

Conclusion: While Chinese general surgeons have an understanding of the whole-process GIST management concept, there is a gap between guideline adherence and clinical practice. The corresponding population should be strengthened with precision training for promoting GIST whole-process management concepts is key, and influencing factors, such as hospital level, regional economy, and hospital’s annual number of GIST operations, should be considered for decision-making.