Xuechao Liu1,2, Haibo Qiu1,2, Peng Zhang3, Xingyu Feng4, Tao Chen5, Yong Li4, Kaixiong Tao3, Guoxin Li5, Xiaowei Sun1,2, Zhiwei Zhou1,2. 1. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. 2. Department of Gastric Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. 3. Department of General Surgery, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan 430022, China 4. Department of General Surgery, Guangdong General Hospital, Guangzhou 510080, China 5. Department of General Surgery, Southern Medical University Nanfang Hospital, Guangzhou 510060, China
Abstract
Objective: We aimed to evaluate the clinicopathologic characteristics, immunohistochemical expression and prognostic factors of patients with primary gastrointestinal stromal tumors (GISTs). Methods: Data from 2,570 consecutive GIST patients from four medical centers in China (January 2001-December 2015) were reviewed. Survival curves were constructed by the Kaplan-Meier method, and Cox regression models were used to identify independent prognostic factors. Results: Of the included patients, 1,375 (53.5%) were male, and the patient age range was 18 to 95 (median, 58) years. The tumors were mostly found in the stomach (64.5%), small intestine (25.1%) and colorectal region (5.1%). At the time of diagnosis, the median tumor size was 4.0 (range: 0.1-55.0) cm, and the median mitotic index per 50 high power fields (HPFs) was 3 (range: 0-254). Of the 2,168 resected patients, 2,009 (92.7%) received curative resection. According to the modified National Institutes of Health (NIH) classification, 21.9%, 28.9%, 14.1% and 35.1% were very low-, low-, intermediate- and high-risk tumors, respectively. The rate of positivity was 96.4% for c-Kit, 87.1% for CD34, 96.9% for delay of germination 1 (DOG-1), 8.0% for S-100, 31.0% for smooth muscle actin (SMA) and 5.1% for desmin. However, the prognostic value of each was limited. Multivariate analysis showed that age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors. Furthermore, we found that high-risk patients benefited significantly from postoperative imatinib (P<0.001), whereas intermediate-risk patients did not (P=0.954). Conclusions: Age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors in patients with GISTs. Moreover, determining whether intermediate-risk patients can benefit from adjuvant imatinib would be of considerable interest in future studies.
Objective: We aimed to evaluate the clinicopathologic characteristics, immunohistochemical expression and prognostic factors of patients with primary gastrointestinal stromal tumors (GISTs). Methods: Data from 2,570 consecutive GISTpatients from four medical centers in China (January 2001-December 2015) were reviewed. Survival curves were constructed by the Kaplan-Meier method, and Cox regression models were used to identify independent prognostic factors. Results: Of the included patients, 1,375 (53.5%) were male, and the patient age range was 18 to 95 (median, 58) years. The tumors were mostly found in the stomach (64.5%), small intestine (25.1%) and colorectal region (5.1%). At the time of diagnosis, the median tumor size was 4.0 (range: 0.1-55.0) cm, and the median mitotic index per 50 high power fields (HPFs) was 3 (range: 0-254). Of the 2,168 resected patients, 2,009 (92.7%) received curative resection. According to the modified National Institutes of Health (NIH) classification, 21.9%, 28.9%, 14.1% and 35.1% were very low-, low-, intermediate- and high-risk tumors, respectively. The rate of positivity was 96.4% for c-Kit, 87.1% for CD34, 96.9% for delay of germination 1 (DOG-1), 8.0% for S-100, 31.0% for smooth muscle actin (SMA) and 5.1% for desmin. However, the prognostic value of each was limited. Multivariate analysis showed that age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors. Furthermore, we found that high-risk patients benefited significantly from postoperative imatinib (P<0.001), whereas intermediate-risk patients did not (P=0.954). Conclusions: Age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors in patients with GISTs. Moreover, determining whether intermediate-risk patients can benefit from adjuvant imatinib would be of considerable interest in future studies.
Authors: Heikki Joensuu; Piotr Rutkowski; Toshirou Nishida; Sonja E Steigen; Peter Brabec; Lukas Plank; Bengt Nilsson; Chiara Braconi; Andrea Bordoni; Magnus K Magnusson; Jozef Sufliarsky; Massimo Federico; Jon G Jonasson; Isabelle Hostein; Pierre-Paul Bringuier; Jean-Francois Emile Journal: J Clin Oncol Date: 2015-01-20 Impact factor: 44.544
Authors: Mee-Yon Cho; Jin Hee Sohn; Joon Mee Kim; Kyoung-Mee Kim; Young Su Park; Woo Ho Kim; Jin Sook Jung; Eun Sun Jung; So-Young Jin; Dae Young Kang; Jae Bok Park; Ho Sung Park; You Duck Choi; Sun Hee Sung; Young-Bae Kim; Hogeun Kim; Young-Kyung Bae; Miseon Kang; Hee Jin Chang; Yang Seok Chae; Hee Eun Lee; Do Youn Park; Youn Soo Lee; Yun Kyung Kang; Hye Kyung Kim; Hee-Kyung Chang; Soon Won Hong; Young Hee Choi; Okran Shin; MiJin Gu; Youn Wha Kim; Gwang Il Kim; Sei Jin Chang Journal: J Korean Med Sci Date: 2010-05-24 Impact factor: 2.153
Authors: Wagner A Nascimento; Carlos Eduardo S Macedo; Fernando Santa-Cruz; Henrique G B Coelho; Daniel T Camelo Soares; Álvaro A B Ferraz Journal: Int J Surg Case Rep Date: 2020-08-29