Gastrointestinal Stromal Tumors Risk of Recurrence Stratification by Tumor Volume is a Best Predictor Compared with Risk Based on Mitosis and Tumor Size

Lino‐Silva, Leonardo S.; Segales-Rojas, Patricia; Aguilar-Cruz, Eduardo; Salcedo‐Hernández, Rosa A.; Zepeda-Najar, César

doi:10.1007/s12029-018-0115-2

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…By contrast, gastric stromal tumors (GSTs) are the most common gastrointestinal mesenchymal tumors, 4,5 of which 20% to 50% are malignant with high risk of recurrence and metastasis, resulting in a poor prognosis. [6][7][8][9] Both GLs and small GSTs tend to have similar clinical presentations and imaging findings so they could be easily misdiagnosed, highlighting the imperative need for preoperative accurate differentiation of GLs from small GSTs.…”

Section: Introductionmentioning

confidence: 99%

Value of CT Imaging in the Differentiation of Gastric Leiomyoma From Gastric Stromal Tumor

Wang

Zhou

et al. 2020

Can Assoc Radiol J

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Purpose: To discuss significant computed tomography (CT) findings that differentiate gastric leiomyomas (GLs) from small gastric stromal tumors (GSTs). Methods: One hundred sixty cases with pathologically proven GLs (n = 50) and GSTs (n = 110) with comprehensive CT images were enrolled in this retrospective study. Computed tomography findings (ie, size, location, contour, growth pattern, enhancement degree, necrosis, ulceration, calcification, and lymph nodes) were analyzed through the χ2 or Fisher exact test, independent T test, and multivariate (logistic regression) analysis. Sensitivity and specificity were also calculated. Results: Features of cardia location, endophytic growth, homogeneous gradual enhancement, absent of necrosis, long diameter less than 24 mm, short diameter less than 20 mm, unenhanced CT value larger than 35.2 Hounsfield units (HU), portal venous phase CT value larger than 67.4 HU, and enhancement degree of arterial and venous phase less than 16.2 HU and 32.4 HU were found to be statistically significant between GLs and small GSTs ( P < .05). On multivariate analysis, cardia location, endophytic growth, and homogeneous gradual enhancement were independent predictive factors for GLs and small GSTs. Conclusion: These 10 CT criteria are very helpful to differentiate GLs from small GSTs. Especially cardia location, endophytic growth, and homogeneous gradual enhancement are of high value in differential diagnosis.

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Section: Introductionmentioning

confidence: 99%

Value of CT Imaging in the Differentiation of Gastric Leiomyoma From Gastric Stromal Tumor

Wang

Zhou

et al. 2020

Can Assoc Radiol J

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“…Despite equal gender distribution in adult GIST populations, female sex predominated in pediatric GIST, as has been reported previously [ 4 , 18 ]. Gastric GIST accounts for approximately 50% of all cases encountered in the general population [ 7 , 12 , 16 ] whereas the vast majority of pediatric GIST tumors (> 80%) are located in the stomach as reported here and by Benesch et al [ 18 ]. Previously, male sex [ 2 , 19 ] and non-gastric location [ 2 ] have been identified as adverse prognostic factors in GIST.…”

Section: Discussionmentioning

confidence: 56%

“…Tumor size is an identified risk factor for poor prognosis in GIST [ 7 , 11 , 12 ]. Similarly, a higher mitotic index is a predictor of tumor recurrence and/or metastatic disease [ 13 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

Current treatment and outcomes of pediatric gastrointestinal stromal tumors (GIST): a systematic review of published studies

et al. 2021

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Gastrointestinal stromal tumor (GIST) is a rare cancer of mesenchymal origin mostly seen in adult and elderly populations. Therefore, the prognostic and therapeutic features of pediatric GIST are not clearly defined. Clinical knowledge has been largely extrapolated from case series and adult studies. In this systematic review, we aimed to analyze the health outcome metrics of pediatric GIST. Medline and Embase databases were searched using relevant key terms. The original search retrieved 1,892 titles; 27 studies with 184 patients (68% female) were included for final review. The primary tumors were located in the stomach (165/184, 90%), small bowel (12/184, 7%), and elsewhere (7/184, 4%). Individual patient data were available in 125 cases with a median follow-up of 6.7 years. All patients underwent surgical resection, which varied from wide local excision to total gastrectomy. There were 12 deaths (10%), 65 (52%) patients were alive with no evidence of disease, and 31 cases (25%) were alive with disease. Tumor size > 5 cm, high mitotic index, and spindle morphology were predictive of mortality. Pediatric GIST has a more favorable prognosis and different characteristics versus adult tumors. There is a crucial need for international consensus and specific pediatric guidelines for the treatment of this rare tumor.

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“…A study of 56 patients with liver metastasis suggested that 3D volume was a better method to evaluate the risk of liver metastasis after imatinib treatment than the tumor long axis [14]. In addition, a recent study of patients with metastatic as well as non-metastatic GIST found that tumor volume was a better measure of the risk of recurrence than the maximum length or the mitotic count [9].…”

Section: Discussionmentioning

confidence: 99%

“…Since GISTs are not spherical, it was thought that assessing tumor volume would be more helpful than measuring tumor size (longest dimension). Therefore, recent studies have used volume for evaluating the metastatic and malignant potential of GISTs [8][9][10]. The Choi criteria have been developed for assessing responses to imatinib in GIST patients, and a method of evaluating responses by combining morphological tumor response and biological response (tumor density, CT attenuation coefficient (Hounsfield units [HU]) has been presented.…”

Section: Introductionmentioning

confidence: 99%

Correlation between Three-Dimensional Volume and Malignant Potential of Gastrointestinal Stromal Tumors (GISTs)

Park

Kang

Lee

et al. 2020

JCM

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Background and purpose: Gastrointestinal stromal tumors (GISTs) are rare diseases of the gastrointestinal tract but they are the most common gastrointestinal tumors of mesenchymal origin. Since most GISTs have malignant potential, their probability of malignant progression must be evaluated. This study was conducted to examine the correlation between three-dimensional GIST volume measured by CT and malignant potential. Materials and methods: A retrospective study was performed on 70 patients diagnosed with GIST after surgical resection in Hanyang University Seoul Hospital from 2012 to 2017. Linear regression analysis was used to establish which between the length of the long axis of GISTs, originally considered a predictor of malignancy, and their volume was a more accurate predictor of malignancy. Tumor dimensions were measured by CT. Results: Data were analyzed using the chi-square test or Student’s t-test and logistic regression. Of the GISTs, 53 (75.71%) were in the stomach, 3 (4.29%) in the small intestine, and 14 (20.0%) in the large intestine. The mean age of the malignant GIST group was significantly higher than that of the benign GIST group (p = 0.032), their tumor long axes were significantly greater (p = 0.073), their tumor volumes were significantly larger (p = 0.001), and the frequency of tumor necrosis was higher (p = 0.001). In multivariate analysis, malignant GIST was associated with location in organs other than the stomach (OR 7.846, 95% CI 1.293–47.624, p = 0.025), longer axis (OR 1.037, 95% CI 1.011–1.065, p = 0.006), larger volume (OR 1.003, 95% CI 1.000–1.006, p = 0.029), and necrosis (OR 12.222, 95% CI 1.945–76.794, p = 0.008). The mean age of the recurrent GIST group was higher than that of the non-recurrent group (p = 0.045), their tumor long axes were significantly longer (p = 0.005), and their volumes were greater, but this last difference was not significant (p = 0.072). Conclusions: Tumor volume can be considered an additional risk factor in assessing the malignant potential of GISTs and tends to increase in recurrent GISTs.

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Gastrointestinal Stromal Tumors Risk of Recurrence Stratification by Tumor Volume is a Best Predictor Compared with Risk Based on Mitosis and Tumor Size

Abstract: Tumor volumetry calculated in the surgical specimen and/or pre-operative tomography was superior to the NIH consensus in stratifying the risk of recurrence in GIST.

Cited by 12 publications

References 12 publications

Value of CT Imaging in the Differentiation of Gastric Leiomyoma From Gastric Stromal Tumor

Value of CT Imaging in the Differentiation of Gastric Leiomyoma From Gastric Stromal Tumor

Current treatment and outcomes of pediatric gastrointestinal stromal tumors (GIST): a systematic review of published studies

Correlation between Three-Dimensional Volume and Malignant Potential of Gastrointestinal Stromal Tumors (GISTs)

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