A cohort study of prognostic factors associated with recurrence or metastasis of gastrointestinal stromal tumor (GIST) of stomach

Supsamutchai, Chairat; Wilasrusmee, Chumpon; Hiranyatheb, Pitichote; Jirasiritham, Jakrapan; Rakchob, T.; Choikrua, Pattawia

doi:10.1016/j.amsu.2018.08.010

Cited by 17 publications

(12 citation statements)

References 19 publications

(22 reference statements)

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“…This study was dedicated to building a comprehensive scoring system and made up for these shortcomings. Meanwhile, most studies estimated the metastatic risk of GIST based on tumor location, tumor size, and mitotic count but ignored some other features of tumor [2,7,8]. Our nomogram showed that small intestine held the highest metastatic risk.…”

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confidence: 90%

Establishment and Verification of Synchronous Metastatic Nomogram for Gastrointestinal Stromal Tumors (GISTs): A Population-Based Analysis

Zhang

Song

et al. 2020

Gastroenterology Research and Practice

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Aim. Assess the risk of synchronous metastasis and establish a nomogram in patients with GISTs. Methods. Surveillance, Epidemiology and End Results database (2004-2014) was accessed. With the logistic regression model as the basis, a nomogram was constructed. Results. 7,256 target patients were contained in our study. The nomogram discrimination for mGIST prediction revealed that tumor size contributed most to synchronous metastasis, followed by lymph nodes, extension, pathologic grade, tumor location, and mitotic count. C-index values of predictions were 0.821 (95% CI, 0.805-0.836) and 0.815 (95% CI, 0.800-0.831), and Brier score were 0.109 and 0.112 in training and validation group, respectively. The value of area under the ROCs were 0.813 (p<0.001) in the primary cohort and 0.819 (p<0.001) in the validation cohort. Through the calibration curves (as seen in the figures), nomogram prediction proved to have excellent agreement with actual metastatic diseases. Conclusion. A new nomogram was created that can evaluate synchronous metastatic diseases in patients with GISTs.

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confidence: 90%

Establishment and Verification of Synchronous Metastatic Nomogram for Gastrointestinal Stromal Tumors (GISTs): A Population-Based Analysis

Zhang

Song

et al. 2020

Gastroenterology Research and Practice

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“…While most GISTs are found in the stomach, 20% to 30% are present in the small intestine, 5% to 15% present in the colon, and less than 5% present in the esophagus and other regions [ 8 , 14 , 15 , 16 ]. Although the only principal treatment of localized GISTs is surgical resection with negative margins, there is a risk for recurrence or metastasis; one cohort study reported that 29.4% of cases showed recurrence or metastasis following curative resection of gastric GISTs during a median 31.95 months of follow-up [ 17 ]. Our study revealed a lower recurrence rate of 2.7%, which may be the result of bias due to our small sample size and inclusion of only patients with gastric GISTs who underwent curative surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Is There Pathological Uniformity between the Periphery and Center of a Gastrointestinal Stromal Tumor?

Choi

Lee

Yoo

et al. 2021

JCM

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Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and have some malignant potential. Mitotic count is important for predicting the malignant potential of GISTs. Proper treatment of GISTs requires accurate pathological diagnosis. In general, endoscopic ultrasound-guided fine-needle aspiration and deep biopsy are used for pathological diagnosis of GIST before making decisions about surgery. This study sought to evaluate the pathological uniformity of gastric GISTs for mitotic index of the center and periphery of the GIST. Methods: We retrospectively reviewed the data of 37 gastric GIST patients who underwent wedge resection at Hanyang University Hospital. We used Armed Forces Institute of Pathology criteria to classify gastric GISTs. To determine the pathological uniformity of gastric GISTs, we compared GIST risk stratification between the center and periphery of GISTs. Results: The mean size of GISTs was 3.56 ± 2.10 cm. Three lesions were located in the antrum, 11 in the fundus, 9 in the cardia, and 14 in the body. The mean age of patients was 58.65 ± 9.44 years; 18 patients were male and 19 were female. Thirty-five patients (94.6%) showed the same level of risk stratification between the center and periphery of gastric GISTs, while two patients (5.4%) presented different levels of risk between the two sites. No significant difference in mitotic count was observed between the two sites (kappa value = 0.863; p = 0.001). Conclusions: Mitotic index category (either more than five mitoses per high-power field or five or fewer mitoses per high-power field) of GISTs showed good concurrence between the center and periphery.

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“…They also found that metastasis correlated with tumor size > 10 cm ( P = 0.023) and mitotic count > 5/5 mm 2 ( P = 0.000). In the study of Supsamutchai et al[ 15 ], they demonstrated that there were significant differences between mitotic index or tumor size and the risk of recurrence or metastasis ( P = 0.036). Our data demonstrated that tumor location was also an important factor affecting recurrence.…”

Section: Discussionmentioning

confidence: 99%

Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study

Chen

Feng

et al. 2019

WJG

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BACKGROUNDGastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIMTo evaluate the application value of four different risk stratification systems for GISTs.METHODSPatients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health (NIH) criteria, the Armed Forces Institute of Pathology (AFIP) criteria, the Memorial Sloan Kettering Cancer Center (MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic (ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve (AUC).RESULTSA total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields (HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size > 5 cm (P < 0.05), mitotic count > 5/50 HPFs (P < 0.05), non-gastric location (P < 0.05), and tumor rupture (P < 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC (0.754).CONCLUSIONAccording to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs.

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A cohort study of prognostic factors associated with recurrence or metastasis of gastrointestinal stromal tumor (GIST) of stomach

Cited by 17 publications

References 19 publications

Establishment and Verification of Synchronous Metastatic Nomogram for Gastrointestinal Stromal Tumors (GISTs): A Population-Based Analysis

Establishment and Verification of Synchronous Metastatic Nomogram for Gastrointestinal Stromal Tumors (GISTs): A Population-Based Analysis

Is There Pathological Uniformity between the Periphery and Center of a Gastrointestinal Stromal Tumor?

Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study

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