Multicenter study of guideline-based follow-up outcomes in patients with gastrointestinal stromal tumor at low risk of recurrence

Gastrointestinal stromal tumor (GIST) follow-up is recommended by international guidelines, but data on the role of follow-up in patients with low relapse risk are lacking. For these patients, the potential benefit of anticipating recurrence detection should be weighed againts psychological burden and radiologic examination loads in terms of costs and radiation exposure. A multicenter cohort study in Italy included 737 patients with low-risk GIST, who underwent surgery and were followed-up according to ESMO guidelines. With a median follow-up of 69.2 months, 42 patients (5.7%) experienced relapse. This translated to 1 relapse detected every 179 CT scans performed. Second tumors affected 25% of patients, representing the leading cause of death in this population. The authors conclude that in low-risk GIST, relapses are uncommon. Current follow-up schedules for low-risk GIST may need to be revised.