A proposed risk assessment score for gastrointestinal stromal tumors based on evaluation of 19,030 cases from the National Cancer Database

Risk stratification of oesophageal, colonic, and appendiceal gastrointestinal stromal tumours (GISTs) using the new Nashville risk score

“…Trinh et al . recently proposed a simple risk assessment tool for GIST (the Nashville Risk Score [NRS]) based on optimized cutoff values for tumour size and mitotic count 5 . In this study, the authors queried the National Cancer Database (NCDB) to identify 19 030 patients with GIST and found that tumour size, mitotic rate, tumour multifocality, and anatomic location were independently associated with increased odds of metastasis at presentation.…”

“…The optimal tumour size cutoff of 7 cm was determined by evaluation of receiver‐operator characteristic curves, the threshold mitotic rate of 10 per 5 mm 2 was selected based on logistic regression with cubic splines, and the association of anatomic site was determined by pairwise comparison of coefficients in a multivariate logistic regression model. Based on these optimal cutoff values of tumour size and mitotic rate, together with anatomic site (gastric vs. non‐gastric) and multifocality (unifocal versus multifocal), the authors proposed the NRS and found it outperformed the AFIP criteria and AJCC 8th staging systems for predicting metastasis at diagnosis and 4‐year overall survival 5 …”

“…Trinh et al recently proposed a simple risk assessment tool for GIST (the Nashville Risk Score [NRS]) based on optimized cutoff values for tumour size and mitotic count. 5 In this study, the authors queried the National Cancer Database (NCDB) to identify 19 030 patients with GIST and found that tumour size, mitotic rate, tumour multifocality, and anatomic location were independently associated with increased odds of metastasis at presentation. The optimal tumour size cutoff of 7 cm was determined by evaluation of receiver-operator characteristic curves, the threshold mitotic rate of 10 per 5 mm 2 was selected based on logistic regression with cubic splines, and the association of anatomic site was determined by pairwise comparison of coefficients in a multivariate logistic regression model.…”

“…Based on these optimal cutoff values of tumour size and mitotic rate, together with anatomic site (gastric vs. non-gastric) and multifocality (unifocal versus multifocal), the authors proposed the NRS and found it outperformed the AFIP criteria and AJCC 8th staging systems for predicting metastasis at diagnosis and 4-year overall survival. 5 The Trinh study was based predominantly on gastric, small intestinal, and colonic GISTs. 5 But since the NCDB lacks key outcome data, disease-free and progression-free survival could not be evaluated.…”

“…5 The Trinh study was based predominantly on gastric, small intestinal, and colonic GISTs. 5 But since the NCDB lacks key outcome data, disease-free and progression-free survival could not be evaluated. Moreover, appendiceal GIST were not included and the number of oesophageal tumours was limited.…”