{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T08:07:13Z","timestamp":1783843633256,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32"],"award-info":[{"award-number":["T32"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA121938"],"award-info":[{"award-number":["CA121938"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01"],"award-info":[{"award-number":["R01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["FD006334"],"award-info":[{"award-number":["FD006334"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01"],"award-info":[{"award-number":["U01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA278470"],"award-info":[{"award-number":["CA278470"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA292590"],"award-info":[{"award-number":["CA292590"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30"],"award-info":[{"award-number":["P30"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA023100"],"award-info":[{"award-number":["CA023100"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Succinate dehydrogenase\u2010deficient (SDH\u2010deficient) gastrointestinal stromal tumors (GIST) are characterized by variable disease biology with poor responses to traditional tyrosine kinase inhibitors. The role of surgical intervention has been highly debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a single\u2010institution retrospective analysis of metastatic SDH\u2010deficient GIST patients who underwent complete (CC\u20100) cytoreductive surgery (CRS) from 2017 to 2023. Pathologic\u2010Peritoneal Cancer Index (P\u2010PCI) and GIST Metastatectomy\u2010Surgical Complexity Score (GM\u2010SCS) were used to quantify complexity. Kaplan\u2010Meier survival analysis compared time to progression on systemic therapy immediately before CRS (TTP\u20101L) and second to last line of systemic therapy before CRS (TTP\u20102L)\n                      <jats:italic>versus<\/jats:italic>\n                      time to recurrence (TTR) after CRS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine patients met inclusion criteria. The median age at CRS was 29 years (range: 17\u201343). Median P\u2010PCI was 13 (IQR: 10\u201315) and median GM\u2010SCS was 19 (IQR: 16\u201328). Clavien\u2010Dindo grade \u2265\u20093 complication rate was 33.3% (3\/9) within 90\u2010days postoperatively. Median TTP\u20101L was unreached and median TTP\u20102L was 3.4 months (95% CI: 2.5\u2013unreached), as compared to TTR at 26.1 months (95% CI: 15.2\u2013unreached) post CRS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients who underwent CC\u20100 CRS achieved prolonged disease control versus prior systemic therapies, suggesting that CRS may be a management option for highly selected SDH\u2010deficient GIST patients.<\/jats:p>\n                  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