ABSTRACT
A zinc-mediated cross-electrophile coupling of benzyl sulfonium salts with thiosulfonates via C-S bond cleavage was achieved. The reductive thiolation proceeded well under transition metal-free conditions to afford the desired benzyl sulfides in good yields, exhibiting both broad substrate scope and good functionality tolerance. In addition, the reaction could be applied to the use of selenosulfonate as an effective selenylation agent and be subjected to scale-up synthesis.
ABSTRACT
BACKGROUND: The optimal surgical modality for duodenal gastrointestinal stromal tumor (GIST) remains undefined. The purpose of this study was to evaluate long-term survival outcomes of patients who underwent radical resection (RR) or limited resection (LR) of duodenal GIST. METHODS: A total of 325 patients identified from the Surveillance, Epidemiology and End Results (SEER) database who underwent surgery for duodenal GIST between 1986 and 2016 were classified into a LR group and a RR group based on the type of surgery received. Propensity score matching (PSM) was performed to minimize the selection bias in comparisons. Disease-specific survival (DSS) and overall survival (OS) were observed, and factors affecting the survival outcome were analyzed. RESULTS: In the entire cohort, 105 patients (32.3%) underwent RR and 220 (67.7%) received LR. Both the 5-year OS and DSS in RR group were significantly better than those in LR group (71.0% vs. 54.1%, P = 0.014; 66.6% vs. 49.1%, P = 0.025). PSM resulted in 95 pairs of patients, with long-term outcomes being comparable between the two groups. After adjusting covariates in the propensity matched cohort, the type of surgery still showed no significant impact on OS (hazard ratio [HR] 1.160; 95% confidence interval [CI] 0.662-2.033) and DSS (HR 1.208; 95% CI 0.686-2.128). CONCLUSIONS: Surgical modalities do not seem to have a significant impact on long-term survival outcomes of patients with duodenal GIST and should mainly depend on the tumor size and location.