2020
DOI: 10.1002/jso.26294
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Tumor necrosis is significantly associated with reduced recurrence‐free survival after curative resection of gastrointestinal stromal tumors

Abstract: Background ObjectivesThe impact of tumor necrosis as a prognostic factor in gastrointestinal stromal tumor (GISTs) is still debated. The objective was to determine whether tumor necrosis is an independent risk factor for survival in patients with GISTs.MethodsPatients undergoing surgery for primary GIST from March 2003 to October 2018 at two sarcoma referral centers were retrospectively identified. Patients who received neoadjuvant imatinib were excluded. Multivariable Cox regression models were produced, to a… Show more

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Cited by 7 publications
(4 citation statements)
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“…Surprisingly, tumor size was not related to DFS in the univariate or multivariate Cox regression models after PSM ( Table 3 ). Tumor necrosis was a key risk factor for not including EGIST data in previous studies [ 21 ], which was inconsistent with the current finding that tumor necrosis was not an independent risk factor in the multivariate Cox regression model (Tables 2 and 3 ). In any case, tumor location was negatively correlated with OS (before PSM in multivariate Cox regression model: HR, 2.43, 95% CI, 1.13–5.22; after PSM in multivariate Cox regression model: HR, 4.32, 95% CI, 1.22–15.26) or DFS (before PSM in multivariate Cox regression model: HR, 4.79, 95% CI, 2.20–10.43; after PSM in multivariate Cox regression model: HR, 9.79, 95% CI, 2.22–43.31), which was also intuitively shown in the Kaplan–Meier survival curves ( Figure 1 ).…”
Section: Resultscontrasting
confidence: 99%
“…Surprisingly, tumor size was not related to DFS in the univariate or multivariate Cox regression models after PSM ( Table 3 ). Tumor necrosis was a key risk factor for not including EGIST data in previous studies [ 21 ], which was inconsistent with the current finding that tumor necrosis was not an independent risk factor in the multivariate Cox regression model (Tables 2 and 3 ). In any case, tumor location was negatively correlated with OS (before PSM in multivariate Cox regression model: HR, 2.43, 95% CI, 1.13–5.22; after PSM in multivariate Cox regression model: HR, 4.32, 95% CI, 1.22–15.26) or DFS (before PSM in multivariate Cox regression model: HR, 4.79, 95% CI, 2.20–10.43; after PSM in multivariate Cox regression model: HR, 9.79, 95% CI, 2.22–43.31), which was also intuitively shown in the Kaplan–Meier survival curves ( Figure 1 ).…”
Section: Resultscontrasting
confidence: 99%
“…Even more, tumor ulceration was linked to high mitotic rates. 26 In our study, tumor necrosis, tumor ulceration, and high-grade tumors were also more common in GISTs with recurrence.…”
Section: Discussionsupporting
confidence: 58%
“…It was therefore at high risk of recurrence. Furthermore, the presence of tumour necrosis classifies the tumour as high grade malignant with a significantly higher risk of recurrence compared to non-necrotic tumours [8] , [9] . The treatment of retroperitoneal GISTs is not clearly standardised because of their rarity [2] , [3] .…”
Section: Discussionmentioning
confidence: 99%