The following is a summary of “Utility and costs of surveillance imaging for low- and very low-risk gastrointestinal stromal tumors,” published in the December 2023 issue of Surgery by Khan et al.
In the context of low- and very low-risk gastrointestinal stromal tumors (GISTs), the current strategies for surveillance need a standardized approach, leading to varied and often arbitrary methods. This retrospective study delved into their institutional practices regarding surveillance for these tumors and scrutinized the associated expenses involved in recurrence detection. We reviewed the medical records of consecutive adult patients treated for low- and very low-risk GISTs from 2010 to 2019. Data encompassed patient demographics, tumor characteristics, treatment modalities, and subsequent follow-up.
Utilizing their institution’s average cost estimations, we conducted a cost analysis, evaluating yearly expenses based on the employed surveillance methods. Among the 60 included patients, the mean age at diagnosis was 63.9 years, with the majority having primary tumors located in the stomach. The most prevalent surveillance modality involved computed tomography scans of the abdomen and pelvis with intravenous contrast, totaling 226 scans. However, no recurrence instances were detected during a median follow-up duration of 49.0 months.
On average, patients underwent four surveillance images, and a significant majority (83%) received imaging more frequently than annually. This surveillance strategy incurred an estimated yearly cost of $2,840.77 (with an interquartile range of $2,273.62–$3,895.92) per patient without detecting recurrences. The study findings underscore a pattern of frequent and costly surveillance imaging for low- and very low-risk GISTs that yielded no indications of recurrence. The study advocates for extensive, multi-institutional investigations to establish refined surveillance recommendations based on practice patterns and clinical outcomes.
Source: sciencedirect.com/science/article/abs/pii/S0039606023008048
