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Invited Commentary |

Tailoring GIST Therapy—Biology Is Still King

Ajay V. Maker, MD1
[+] Author Affiliations
1Division of Surgical Oncology, Departments of Surgery and Microbiology and Immunology, University of Illinois at Chicago
JAMA Surg. 2015;150(4):306-307. doi:10.1001/jamasurg.2014.2905.
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The apparent rise in the incidence of gastrointestinal stromal tumors (GISTs),1 as well as the determination of high-risk features, has led to the development of risk stratification tools and nomograms to predict disease-free survival (DFS) after resection.2 In this issue of JAMA Surgery, Bischof et al3 have taken the maturation of this field to the next step by determining the conditional DFS (CDFS). As in other cancers,4,5 the probability of survival increased as the DFS interval increased. Because the difference between actuarial DFS and CDFS was most pronounced for those with the highest risk of recurrence, this population may benefit the most from recalculation of their DFS with every year that passes. This information is useful for patients who desire a more accurate estimation of dynamic prognosis and may help shape surveillance plans, thereby reducing physician visits and costly cross-sectional imaging.

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