Prognostic Factors for Survival post Surgery for Patients with Gastrointestinal Stromal Tumors

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms located in the alimentary tract. Our aim was to assess the influence of prognostic factors on survival in patients surgically treated for GISTs. Study: One hundred and five patients treated between January 1989 and December 2008 were available for study. A retrospective analysis of prognostic factors (age, gender, mitotic index, tumor location, tumor size, risk of malignant behavior, and coexisting other neoplasm) was performed. Univariate and multivariate survival analyses were undertaken. Results: Univariate analyses revealed the importance of patient gender (p = 0.007), disease location (p = 0.055), mitotic index (p = 0.054) and coexistence with other neoplasms (p = 0.004). However, multivariate analysis showed 3 independently statistically significant factors: coexistence with other neoplasm (RR = 3.53, p = 0.004), male gender (RR = 2.60, p = 0.011) and mitotic index ≧10/50 HPF, (RR = 2.60, p = 0.042). Conclusions: Our study has shown that male gender, a high mitotic index ≧10/50 HPF, and coexistence with other malignant neoplasms were independent poor prognostic factors in patients with GIST. The presence of middle or lower gut disease location leads to an increased risk of mortality when compared with the upper gut.

A Retrospective Study of Postoperative Outcomes in 98 Patients Diagnosed with Gastrointestinal Stromal Tumor (GIST) of the Upper, Middle, and Lower Gastrointestinal Tract Between 2009 and 2019 at a Single Center in Poland

“…The most common site of GIST in our study was the stomach, which is in keeping with most clinical reports [ 3 , 20 , 32 – 34 ]. The question still remains, is tumor location of any significance as a prognostic factor?…”

“…The question still remains, is tumor location of any significance as a prognostic factor? Some studies insist that it does [ 1 , 20 , 21 , 32 – 42 ], while others say it does not hold any statistical relevance [ 43 – 47 ]. Our data correspond more to the latter one.…”

“…Conflicting reports about the different clinical and histopathological factors affecting prognosis in patients with GIST have emerged [ 11 , 20 – 24 ]. Therefore, this retrospective study between 2009 and 2019 from a single center in Poland aimed to investigate postoperative outcomes and selected prognostic factors in 98 patients diagnosed with gastrointestinal stromal tumor (GIST) of the upper, middle, and lower gastrointestinal tract.…”

Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors in Chinese patients

“…Through multivariate analysis, higher mitotic rate and tumor metastasis or local invasion prior to treatment were revealed to be associated with poor survival in GIST patients, and non-gastric disease location was associated with tumor recurrence, which is consistent with the results of previous studies ( 16 ). Similarly, one British study ( 17 ) identified high mitotic index as an independent poor prognostic factor in these patients. Miettinen and Lasota ( 37 ) also demonstrated that small intestinal GISTs behave more aggressively than gastric GISTs, and small intestinal GISTs tend to be larger and more advanced at diagnosis.…”

“…The following details of these patients were collected: Age, sex, symptoms and signs, preoperative investigations, surgical details, pathology and follow-up data. The tumor site was analyzed according to previous classification methods ( 16 , 17 ). Preoperative investigations comprised radiological and endoscopic examinations, including gastroscopy, abdominal CT, MRI, colonoscopy, small intestinal endoscopy, capsule endoscopy and positron emission tomography (PET)-CT.…”