The accuracy of three predictive models in the evaluation of recurrence rates for gastrointestinal stromal tumors

Racz, Jennifer M.; Brar, Savtaj; Cleghorn, Michelle C.; Jimenez, M. Carolina; Azin, Arash; Atenafu, Eshetu G.; Jackson, Timothy; Okrainec, Allan; Quereshy, Fayez A.

doi:10.1002/jso.23839

Cited by 11 publications

(8 citation statements)

References 60 publications

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“…Similar to previous studies ( 23 – 26 ), in our study, we found that the recurrence risk of non-gastric GISTs is higher than that of gastric GISTs.…”

Section: Discussionsupporting

confidence: 92%

“…Some researchers consider that it is possible to improve the risk predictive probability of current risk stratification criteria by adding reasonable variables (25,26). To identify additional predictive factors besides tumor site, size, mitotic index, and tumor rupture, this study retrospectively analyzed the clinicopathologic data of patients with GISTs through univariate and multivariate Cox analyses.…”

Section: Discussionmentioning

confidence: 99%

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Novel Prognostic Nomogram for Recurrence-Free Survival of Patients With Primary Gastrointestinal Stromal Tumors After Surgical Resection: Combination of Prognostic Nutritional Index and Basic Variables

Chen

et al. 2021

Front. Oncol.

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BackgroundGastrointestinal stromal tumor (GIST) is the most common type of mesenchymal tumors in the digestive tract, often recrudescing even after R0 resection. Adjuvant tyrosine kinase inhibitor therapy prolonged recurrence-free survival (RFS). This study aimed to develop a novel nomogram for predicting the RFS of patients following surgical resection of GISTs.MethodsClinicopathologic data of patients with GISTs at Tianjin Medical University General Hospital (Tianjin, China) from January 2000 to October 2019 were retrospectively reviewed. Univariate and multivariate Cox regression analyses were used to select the suitable variables from the training cohort to construct a nomogram for 2- and 5-year RFS. The 1,000 bootstrap samples and calibration curves were used to validate the discrimination of the nomogram. The receiver operating characteristic analysis(ROC) was used to compare the predictive ability of the nomogram and present four commonly used risk stratification systems: National Institutes of Health (NIH)–Fletcher staging system; NIH–Miettinen criteria; Modified NIH criteria; and Air Forces Institute of Pathology risk criteria (AFIP).ResultsUnivariate and multivariate analyses showed that the tumor site, tumor size, mitotic index, tumor rupture, and prognostic nutritional index were significant factors associated with RFS. These variables were selected to create the nomogram for 2- and 5-year RFS (all P<0.05). The 2- and 5-year the ROC of the nomogram were 0.821 (95% confidence interval [CI]: 0.740–0.903) and 0.798 (95% CI: 0.739–0.903); NIH–Fletcher criteria were 0.757 (95% CI: 0.667–0.846) and 0.683 (95% CI: 0.613–0.753); NIH–Miettinen criteria were 0.762 (95% CI: 0.678–0.845) and 0.718 (95% CI: 0.653–0.783); Modified NIH criteria were 0.750 (95% CI: 0.661–0.838) and 0.689 (95% CI: 0.619–0.760); and AFIP were 0.777 (95% CI: 0.685–0.869) and 0.708 (95% CI: 0.636–0.780). Hence, the predictive probabilities of our nomogram are better than those of other GIST risk stratification systems.ConclusionThis nomogram, combining tumor site, tumor size, mitotic index, tumor rupture, and prognostic nutritional index, may assist physicians in providing individualized treatment and surveillance protocols for patients with GISTs following surgical resection.

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“…Similar to previous studies ( 23 – 26 ), in our study, we found that the recurrence risk of non-gastric GISTs is higher than that of gastric GISTs.…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Novel Prognostic Nomogram for Recurrence-Free Survival of Patients With Primary Gastrointestinal Stromal Tumors After Surgical Resection: Combination of Prognostic Nutritional Index and Basic Variables

Chen

et al. 2021

Front. Oncol.

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“…Like many cancers, the prognosis of GIST is based upon the occurrence of metastasis. In the past, a number of systems have been designed to assess the risk of recurrence or metastasis occurence in GIST [ 1 , 7 – 10 ]. The AFIP criteria, reported by Miettienen et al is widely used to assess the prognosis of GIST [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…To date, much is known about the histological, immunohistochemical and molecular aspects of GIST especially in diagnostic purposes, it is however obvious that little is known about the clinicopathological features that can predict the biological behavior of these tumors. In fact, several features of GIST have been postulated in the past to predict their clinical behavior [ 1 , 7 – 10 ]. The widely accepted risk stratification of GIST is known as AFIP (Armed Forces Institute of Pathology) criteria, reported by Miettinen et al This system of risk stratification is in fact a modification of a NIH (National Institutes of Health) consensus criteria [ 1 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, several features of GIST have been postulated in the past to predict their clinical behavior [ 1 , 7 – 10 ]. The widely accepted risk stratification of GIST is known as AFIP (Armed Forces Institute of Pathology) criteria, reported by Miettinen et al This system of risk stratification is in fact a modification of a NIH (National Institutes of Health) consensus criteria [ 1 , 9 , 10 ]. To determine the risk of recurrence, the AFIP criteria takes into account tumor size and mitotic count/50 HPF (high power field), according to the anatomic location of the tumor.…”

Section: Introductionmentioning

confidence: 99%

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The expression of MDM2 in gastrointestinal stromal tumors: immunohistochemical analysis of 35 cases

et al. 2018

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BackgroundGastrointestinal stromal tumors (GIST) are the most common primary mesenchymal tumors of the digestive system. The assessment of their biological behavior still remains a scientific challenge. To date, there are no well-established biological prognostic markers of GIST. Our aim is to study the expression of the MDM2 oncoprotein in GIST through an immunohistochemical analysis.MethodsIt was a retrospective study of 35 cases of GIST diagnosed from 2009 to 2012 in the department of pathology of Hassan II university hospital, Fès, Morocco. MDM2 immunohistochemical staining was performed on archival paraffin-embedded and formalin-fixed specimens (with a threshold of nuclear positivity > 10%). Analysis of correlations between MDM2 immunoexpression and clinicopathological features of GIST has been performed.ResultsThe mean age was 55.23 years (range 25–84 years) with a male predominance (sex ratio = 1.5). The stomach was the main site of GIST, with 17 cases (48.57%) followed by the small bowel (9 cases, 25.71%). The spindle cell type GIST was the most frequent morphological variant (29 cases, 82.85%). Tumor necrosis was present in 8 cases (22.85%). Two patients (5.71%) had very low risk GIST, 5 (14.28%) had low risk GIST, 7 patients (20%) had intermediate risk tumors. The remaining 21 cases (60%) had high risk GIST. At the time of diagnosis, 9 patients (25.71%) had metastatic tumors. At immunohistochemical analysis, 40% of cases (14 patients) stained positive for MDM2. Of these MDMD2-positive tumors, 11/14 (78.57%) had high risk tumors and 8/14 cases (57.14%) presented with metastatic GIST. MDM2 positivity was significantly associated with the metastatic status (p = 0.001).ConclusionThe current study suggests that MDM2 immunohistochemical expression is a negative histoprognostic factor in GIST with a statistically significant correlation with metastasis.

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An interpretable AI model for recurrence prediction after surgery in gastrointestinal stromal tumour: an observational cohort study

Bertsimas,

Margonis,

Tang

et al. 2023

eClinicalMedicine

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The accuracy of three predictive models in the evaluation of recurrence rates for gastrointestinal stromal tumors

Abstract: Development of a novel predictive tool that includes additional prognostic factors may better stratify recurrence following resection for GIST.

Cited by 11 publications

References 60 publications

Novel Prognostic Nomogram for Recurrence-Free Survival of Patients With Primary Gastrointestinal Stromal Tumors After Surgical Resection: Combination of Prognostic Nutritional Index and Basic Variables

Novel Prognostic Nomogram for Recurrence-Free Survival of Patients With Primary Gastrointestinal Stromal Tumors After Surgical Resection: Combination of Prognostic Nutritional Index and Basic Variables

The expression of MDM2 in gastrointestinal stromal tumors: immunohistochemical analysis of 35 cases

An interpretable AI model for recurrence prediction after surgery in gastrointestinal stromal tumour: an observational cohort study

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