Prognostic factors in primary gastrointestinal leiomyosarcoma: A retrospective study

Kimura, Hironobu; Yonemura, Yutaka; Kadoya, Naotaka; Kosaka, Takeo; Miwa, Kouichi; Miyazaki, Itsuo; Sawa, Toshiharu; Yoshimitsu, Sotohiro; Nishida, Yasuhiro; Kamata, Toru; Hirono, Teisuke; Takayanagi, Nobutatsu

doi:10.1007/bf01665316

Cited by 35 publications

(35 citation statements)

References 13 publications

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“…This is the first time that the degree of malignancy was demonstrated by the number of the predictive parameters of malignancy. Previous studies have demonstrated that the adverse outcome of GISTs correlates with the increase in the tumor size, 12,16,25,[50][51][52][53] mitotic rate, 20,25,51,52,54 cellularity 51,52,55 and nuclear atypia. 16 In addition, tumor site 23,56,57 from the upper to lower GI tract seemingly had an effect on the outcome too.…”

Section: Discussionmentioning

confidence: 99%

Stage and histological grade of gastrointestinal stromal tumors based on a new approach are strongly associated with clinical behaviors

Hou

Zhou

et al. 2009

Modern Pathology

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Tumor stage and grade for gastrointestinal stromal tumors are poorly defined. To develop a better evaluation system, we assessed 12 clinical and pathological parameters in 613 patients with follow-up information. These parameters were classified into two gross spread parameters including liver metastasis and peritoneal dissemination, five microscopic spread parameters including lymph node metastasis, vascular, fat, nerve and mucosal infiltration, and five histological parameters including mitotic count Z10 per 50 high-power fields, muscularis propria infiltration, coagulative necrosis, perivascular pattern and severe nuclear atypia. The 5-year disease-free survival and overall survival of 293 patients without any of these predictive parameters of malignancy were 99% and 100%, respectively. They were regarded as nonmalignant and further evaluations on the stage and grade of these tumors were not performed. At least one and at most seven predictive parameters of malignancy were identified in 320 patients. For these patients, the 5-year disease-free survival and overall survival rates were 44% (mean 6.7 years) and 60% (mean 9.3 years), respectively. The disease-free survival showed significant difference between patients with and without gross spread (Po0.0001), with and without microscopic spread (P ¼ 0.0009). Disease-free survival and overall survival were associated with the number of predictive parameters of malignancy in patients without gross spread (Po0.0001 for both disease-free survival and overall survival), but not in patients with gross spread (P ¼ 0.882 and 0.441, respectively). Malignant gastrointestinal stromal tumors could be divided into clinical stage I and II based on the absence and presence of gross spread, respectively. The degree of malignancy of patients in clinical stage I could be graded according to the number of predictive parameters of malignancy. Patients in clinical stage II were of the highest degree of malignancy regardless of the number of parameters. We found that the clinical stage and grade were strongly associated with prognosis.

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Section: Discussionmentioning

confidence: 99%

Stage and histological grade of gastrointestinal stromal tumors based on a new approach are strongly associated with clinical behaviors

Hou

Zhou

et al. 2009

Modern Pathology

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“…Currently, however, tumor size is internationally recognized as an independent and useful prognostic factor, for GISTs at least [37, 38, 39, 40, 41, 42]. In our study as well as others, the mutation-positive tumors were larger than the mutation-negative ones, so it needs to be determined whether not only tumor size but also mutations in exon 11 of the c-kit gene are independent and useful prognostic factors.…”

Section: Discussionmentioning

confidence: 75%

Mutations in Exon 11 of the c-kit Gene in a Myogenic Tumor and a Neurogenic Tumor as Well as in Gastrointestinal Stromal Tumors

Yasuoka

Sakakura²,

Shimomura³

et al. 2003

Dig Surg

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Background/Aims: Gain-of-function mutations in exons 9, 11 and 13 of the c-kit gene in gastrointestinal stromal tumors (GISTs) have been identified, and it has been reported that the prognosis is worse for patients with mutation-positive GISTs than for those with mutation-negative GISTs. We studied c-kit mutations in gastrointestinal mesenchymal tumors. By chance, the c-kit mutation in exon 11 was found in myogenic and neurogenic tumors as well as in GISTs. Furthermore, we studied the clinical prognostic utility of these mutations. Methods: Ten gastrointestinal mesenchymal tumors were stained with HE and immunohistochemically analyzed with α-smooth muscle actin, S-100 protein, CD34 and c-kit. In these tumors, as well as in 11 cases of leiomyomas, PCR-amplified DNA from the juxtamembrane (JM) domain of exon 11, the extracellular domain of exon 9 and the tyrosine kinase domain 1 of exon 13 showed a high frequency of c-kit mutation and was sequenced. Results: Although c-kit mutations have previously been reported only in GISTs, we found c-kit mutations in the JM domain of exon 11 in one myogenic and one neurogenic tumor as well as in two GISTs. No c-kit mutation was seen in the 11 cases of leiomyomas. In addition, all four cases with c-kit mutation in exon 11 suffered a relapse sooner than the other cases without c-kit mutations. Conclusion: Clinically, the prognosis was worse for the patients with mutation-positive gastrointestinal mesenchymal tumors than for those with mutation-negative tumors. We therefore conclude that the gain-of-function mutation in exon 11 of the c-kit gene is an important prognostic factor for gastrointestinal mesenchymal tumors, including myogenic and neurogenic tumors as well as GISTs.

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“…In our case, there was a GIST mass of the stomach showing extra gastric growth [5][6][7]. We reported on a unique and clinically and surgically significant case of GIST.…”

Section: Discussionmentioning

confidence: 94%

“…While there are studies about the severity of mesenchymal tumors by various criteria for malignancy, such as tumor size, cellularity, mitotic index, and DNA content [5], submucosal tumors of the stomach including GISTs have been classified into four growth patterns according to a previous report [6], namely, intragastric, intraluminal, extra gastric, and mixed patterns. In our case, there was a GIST mass of the stomach showing extra gastric growth [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

Incidental diagnosis of extra-gastric gastrointestinal stromal tumor: case report

Şalk¹,

Atalar²,

Çetin³

2014

Basic Clin Sci

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Prognostic factors in primary gastrointestinal leiomyosarcoma: A retrospective study

Cited by 35 publications

References 13 publications

Stage and histological grade of gastrointestinal stromal tumors based on a new approach are strongly associated with clinical behaviors

Stage and histological grade of gastrointestinal stromal tumors based on a new approach are strongly associated with clinical behaviors

Mutations in Exon 11 of the c-kit Gene in a Myogenic Tumor and a Neurogenic Tumor as Well as in Gastrointestinal Stromal Tumors

Incidental diagnosis of extra-gastric gastrointestinal stromal tumor: case report

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