Primary Localized Gastrointestinal Stromal Tumors: Medication Adherence and Prognosis According to Gender

作者全名："Ran, Pan; Li, Juan; Wu, Xingye; Yang, Hao; Zhang, Jun"

作者地址："[Ran, Pan; Wu, Xingye; Zhang, Jun] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Li, Juan] Chongqing Med Univ, Dept Pharm, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Yang, Hao] Chongqing Med Univ, Dept Resp Med, Affiliated Hosp 1, Chongqing 400016, Peoples R China"

通信作者："Zhang, J (通讯作者)，Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Chongqing 400016, Peoples R China."

来源：PATIENT PREFERENCE AND ADHERENCE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000882987800001

JCR分区：Q3

影响因子：2.2

年份：2022

卷号：16

期号：　

开始页：2077

结束页：2087

文献类型：Article

关键词：gastrointestinal stromal tumor; recurrence-free survival; imatinib; medication adherence; gender

摘要："Objective: Gender is associated with medication adherence for imatinib, but whether it is related to the prognosis of primary localized gastrointestinal stromal tumors (GISTs) is unclear. The goal of this study was to clarify the relationship between gender and prognosis in GIST patients, with differences in medication adherence considered. Methods: The data of 320 GIST patients were retrospectively collected from the First Affiliated Hospital of Chongqing Medical University. Survival analysis was performed using the Kaplan-Meier method (Log rank test) and the risk factors of recurrence were determined using Cox multivariate analysis. Medication adherence-stratified analyses were performed to control for confounding factors. Results: Kaplan-Meier analysis revealed that among patients who received postoperative adjuvant imatinib therapy, men had a higher recurrence rate than women (P<0.01). Pearson's chi-square test revealed better medication adherence in women than in men (P<0.01). Cox regression analysis revealed that gender was not an independent risk factor for recurrence-free survival (RFS; P=0.25), but medication adherence was (P<0.01). Among GIST patients with a medication possession ratio (MPR) of less than 90%, 62.86% of male patients took imatinib irregularly or not at all due to limited understanding of the disease, whereas 55.74% of female patients' took imatinib irregularly because they could not tolerate adverse drug reactions. Conclusion: Adherence was poorer in male than in female patients, which might explain the worse prognoses of the former among patients who received adjuvant treatment with imatinib. The gender difference in the degree of adherence should be considered in postoperative pharmacotherapy for patients with primary localized GISTs."

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