Retrospective analysis of 85 cases of intermediate-risk gastrointestinal stromal tumor

Fu, Yang; Hao, He; Guo, Luwei; Yang, Ge; Zhang, Xiefu

doi:10.18632/oncotarget.14359

Cited by 11 publications

(10 citation statements)

References 35 publications

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“…Although adjuvant therapy using imatinib for high-risk patients improves prognosis, some patients do not benefit from therapy due to toxicity. Furthermore, it remains unclear whether intermediate-risk patients with GISTs are candidates for adjuvant therapy [23]. Therefore, a more precise predictive marker is needed to select the patients who will receive significant benefit from adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

The role of FBXW7, a cell-cycle regulator, as a predictive marker of recurrence of gastrointestinal stromal tumors

et al. 2019

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Background Few reliable prognostic markers have been established despite elucidation of the molecular mechanisms of gastrointestinal stromal tumor (GIST) development. We evaluated F-box and WD repeat domain-containing 7 (FBXW7), a cell-cycle-regulating and tumor suppressor, in GISTs. We aimed to determine the clinical relevance of FBXW7 in GISTs and characterize the molecular mechanism of FBXW7 in a GIST cell line. Methods We measured FBXW7 expression in 182 GIST cases, correlated the expression levels with clinicopathological features, and characterized the molecular mechanism underlying suppressed FBXW7 expression in GIST cells in vitro. Results Of the 182 GISTs, 98 (53.8%) and 84 (46.2%) were categorized in the high and low FBXW7 expression groups, respectively. Compared with the high FBXW7 expression group, the low expression group showed a significantly poorer prognosis in terms of recurrence-free (P = 0.01) and overall (P = 0.03) survival. FBXW7 expression was a significant independent factor affecting the 10-year recurrence-free survival rate (P = 0.04). In vitro, FBXW7-specific siRNAs enhanced c-myc and Notch 1 protein expression and upregulated cell proliferation, invasion, and migration. Conclusion FBXW7 is a potential predictive marker of recurrence after curative resection of GISTs. FBXW7 expression may help identify patients benefitting from adjuvant therapy more precisely compared with a conventional risk stratification model.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionmentioning

confidence: 99%

The role of FBXW7, a cell-cycle regulator, as a predictive marker of recurrence of gastrointestinal stromal tumors

et al. 2019

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“…As for Ki-67 proliferation, 10-year overall survival was 84% for patients rated <6% and 65% for those rated ≥6% (p=0.064). KaplanMeier plots are given in Figure 3A-C. and mitotic rate in GISTs (3,(15)(16)(17)(18)(19). Emory et al reported that survival rates were worst for patients with small bowel GIST tumors and best for those with esophageal ones (19).…”

Section: Survival Analysismentioning

confidence: 99%

Gastrointestinal stromal tumors: a clinicopathological and immunohistochemical study of 65 cases

Tepeoğlu

Özgün²,

Tunca³

et al. 2018

TJPATH

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Objective: The clinical behavior of gastrointestinal stromal tumors is divergent. The aim of the present study was to define the clinicopathological features that determine the patient's outcome. Results: Tumors were located in the stomach (n=39, 60%), small intestine (n=22, 33.8%) and large intestine (n=4, 6.2%). Immunohistochemically, CD 117 positivity was found in 90.8%, whereas CD34, Smooth muscle actin, Desmin and S100 positivity was found in 73.3%, 61.7%, 11.7% and 28.3% of tumors respectively. All six ''CD 117-negative'' cases expressed DOG-1. The mean Ki-67 proliferation index was 8.69%±12.76. Liver metastasis was detected in seven cases. A significant association was detected between decreased mean survival time and increased tumor size (p<0.001), large bowel localization (p=0.047), mitosis (p<0.001), the presence of necrosis (p=0.001), metastasis (p=0.033), Ki-67 proliferation index (p=0.002) and risk category (p<0.001). CD 34 positivity was mostly seen in the stomach (p=0.001), and CD 34 positive tumors had longer overall survival (92.85.±5.77 months versus 67.21±13.68 months) (p=0.046). Higher Ki-67 proliferation index (≥6%) was also correlated with the presence of metastases (p=0.015). Conclusion:Our study indicates that in addition to well-known risk factors such as increased tumor size, high mitotic activity and metastasis; higher Ki-67 proliferation index, the presence of necrosis, and CD34 negativity also correlate with shorter survival time.

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“…Although Z9001 trial demonstrated that 1 year of adjuvant imatinib therapy could improve RFS of GIST patients [7], and SSGXVIII/AIO trial found that 3 years of imatinib therapy could improve RFS and overall survival of high risk GIST compared with 1 year Besides tumor size and mitotic index, location is also associated with the prognosis of GISTs, and nongastric GISTs were reported to be more aggressive than gastric GISTs in clinical course [12,13]. In the study reported by Fu et al [10], the prognosis of non-gastric GISTs was signi cantly worse than gastric GISTs. However, this has not been con rmed by multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Benefit of imatinib adjuvant therapy for patients with intermediate risk gastrointestinal stromal tumor: a multi-center retrospective analysis in China

Feng

Fang

Zhang

et al. 2019

Preprint

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Background The benefit of postoperative imatinib therapy on intermediated risk gastrointestinal stromal tumor patients were still under debate. Thus, the present study aims to investigate the impact of imatinib adjuvant therapy on the prognosis of intermediate risk gastrointestinal stromal tumor patients.Methods From January 2000 to April 2018, a total of 450 intermediate risk gastrointestinal stromal tumor patients received R0 resection from eight centers in China were enrolled. The clinicopathological features and prognosis of patients were analyzed. Discrete variables were analyzed using the Chi-square test or Fisher's exact test. Significant predictors for survival identified by univariate analysis and multivariate analysis. Disease-free survival was evaluated by Kaplan-Meier method.Results Among the 450 patients, 109 patients (24.2%) received imatinib treatment. The recurrence rate of patients with and without imatinib treatment was 7.3% and 5.3%, respectively. For the entire cohort, gene mutational status was the only independent risk factor for disease-free survival of patients though univariate and multivariate analysis (P=0.028). For patients without imatinib treatment, tumor location (P=0.025) and gene mutation status (P=0.040) were prognostic factors in univariate analysis. However, only gene mutational status was independent prognostic factor (P=0.037). The disease-free survival of gastrointestinal stromal tumor with exon 11 deletion mutation with and without imatinib treatment were comparable (P=0.531).Conclusions Imatinib adjuvant treatment could not improve the prognosis of intermediate risk gastrointestinal stromal tumors. Intermediate gastrointestinal stromal tumors with exon 11 deletion mutation or non-gastric location may be candidates for imatinib treatment.

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Retrospective analysis of 85 cases of intermediate-risk gastrointestinal stromal tumor

Cited by 11 publications

References 35 publications

The role of FBXW7, a cell-cycle regulator, as a predictive marker of recurrence of gastrointestinal stromal tumors

The role of FBXW7, a cell-cycle regulator, as a predictive marker of recurrence of gastrointestinal stromal tumors

Gastrointestinal stromal tumors: a clinicopathological and immunohistochemical study of 65 cases

Benefit of imatinib adjuvant therapy for patients with intermediate risk gastrointestinal stromal tumor: a multi-center retrospective analysis in China

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