Gastrointestinal Bleeding Is an Independent Risk Factor for Poor Prognosis in GIST Patients

Liu, Qi; Yu-ji, LI; Dong, Ming; Fan-min, Kong; Dong, Qi

doi:10.1155/2017/7152406

Cited by 34 publications

(43 citation statements)

References 20 publications

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“…for s-100 and CD-34, high Ki-67, prolonged prothrombin time, male gender and the presence of metastases are the only significant risk factors that have been associated with bleeding. There have been no consistent relationships reported tumor size and GI bleeding in prior reports [14,[19][20][21]. By contrast, our study showed, that the only risk factor associated with ulceration of gastric GISTs was increased mitotic rate.…”

Section: Discussioncontrasting

confidence: 92%

“…The severity of the GI bleeding varies from occult bleeding and iron deficiency anemia to life-threatening bleeding and hemorrhagic shock [10][11][12][13]. GIST ulceration and GI bleeding have great impact on patient's prognosis, usually being correlated with worse prognosis [8,[14][15][16][17][18][19][20], though there is one report of better prognosis in GISTs that bleed [14].…”

Section: Resultsmentioning

confidence: 99%

“…Gastric GISTs tend to grow toward the serosa but as they enlarge they can also expand into and ulcerate through the gastric mucosa, though this occurs only in a minority of the cases [3,7]. Only a few studies, all from South-East Asia, have addressed why some GISTs penetrate the gastrointestinal mucosa, producing an ulcer and eventually cause GI bleeding [14,[19][20][21].…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal Tumors (GIST)

Eran¹,

Anton²,

Yehuda³

et al. 2019

J Clin Gastroenterol Treat

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Background: Gastrointestinal stromal tumors (GIST) are the most common subepithelial tumors in the gastrointestinal (GI) tract and they are usually located in the stomach. To date, only a few studies have investigated the risk factors for GIST ulceration and bleeding and there have been no prior publications focused on role of Helicobacter pylori in GIST ulceration. The aim of current study was to investigate the risk factors of mucosal ulceration in gastric GISTs. Methods: A retrospective study was conducted of 130 patients with a histological diagnosis of gastric GIST, recruited from four medical centers in Israel. The following details were extracted fom each patient: patient's age and gender; tumor location, size, mitotic rate and Ki-67 index; whether or not metastases were present, the patients' international normalization ratio (INR) and the use of antiplatelets, anticoagulants or proton pump inhibitors (PPI). Results: The median age of the patients was 69 years. Approximately one third of lesions demonstrated a mucosal ulceration. Upper GI bleeding or iron deficiency anemia (77.5%) were the most common indication for endoscopy in patients found to have an ulcerated GIST at endoscopy. On univariate analysis, mucosal ulceration in gastric GIST was associated with older age, increased number of mitoses, high Ki-67 index, location in the cardia and fundus and an elevated INR. Multivariate analysis showed significant differences only for number of mitoses (OR = 1.287, 95% CI 1.054-1.57, p = 0.013). Conclusion: In this large retrospective study, the only risk factor associated with tumor ulceration in gastric GISTs was increased mitotic rate.

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Section: Discussioncontrasting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal Tumors (GIST)

Eran¹,

Anton²,

Yehuda³

et al. 2019

J Clin Gastroenterol Treat

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“…Even if the patient has undergone radical surgery, the recurrence rate is still 40-80% [29]. Patients with uncontrollable gastrointestinal bleeding often require emergency surgery [30]. In addition to surgical treatment, treatment with imatinib mesylate, a small molecule tyrosine kinase inhibitor, signi cantly improved the prognosis of GIST [31].…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of gender in gastric gastrointestinal stromal tumors: A propensity score matching analysis.

Rong

Chen

Song

et al. 2020

Preprint

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Background: Gastrointestinal stromal tumors (GISTs) of the stomach are the most common GISTs. The risk, incidence and outcome of cancer are different between the sexes. Whether gender is related to the prognosis of gastric stromal tumors is unclear. Therefore, this study aims to explore the relationship between gender and gastric GIST prognosis.Methods: Data from gastric GIST patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed to reduce confounding factors, and the clinicopathological features and prognosis of GIST patients were comprehensively evaluated.Results: There were 512 male patients and 538 female patients with gastric GIST. The gender of gastric GIST patients was associated with marital status, surgical treatment, tumor size, and mitotic index (P < 0.05). The Kaplan-Meier analysis and log-rank test revealed that male patients had a higher mortality rate than female patients (P = 0.0024). After matching all the potential confounding factors, the survival of the female gastric GIST patients was better than that of the male gastric GIST patients (P = 0.042). Cox regression analysis revealed that gender was an independent risk factor for overall survival. The risk of death was higher for males than for females (HR: 1.677, 95% CI: 1.150-2.444, P = 0.007). Conclusion: Gender could be a prognostic factor for gastric GIST survival, and male patients had a higher risk of death.

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“…Gastrointestinal bleeding caused by GIST is multifactorial and can be a result of altered local mucosal blood supply, cell necrosis or tumor invading and eroding the mucosal or submucosal blood vessels [14]. Liu et al reported incidence rates of 26.4% and 54.7%, with gastric bleeding vs nongastric bleeding, respectively [15]. The stomach is larger and has more resistance to extrusion by GIST making it less prone to bleed than other non-gastric lesions.…”

Section: Discussionmentioning

confidence: 99%

Recent Anti-platelet Therapy Revealing Underlying Undiagnosed Gastrointestinal Stromal Tumor in Otherwise Healthy Patient

Mehershahi¹,

Ghazanfar

Shaikh³

et al. 2020

Cureus

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Gastrointestinal stromal tumors (GIST) are uncommon tumors of the gastrointestinal (GI) tract that arise from primitive mesenchymal cells. Usually, GIST presents as chronic gastrointestinal symptoms or obscure gastrointestinal bleed. Not many cases have been reported in the literature with acute symptoms in the setting of recent aspirin use. We report a case of 70-yearold male otherwise healthy who presented to the hospital with the complaint of black tarry stool for the past two days after taking one tablet of aspirin once a day for two days. The patient underwent upper endoscopy which showed a moderate size polypoid mass in the gastric fundus. Initially, standard endoscopic biopsy was negative for malignancy, due to high suspicion for GIST, later the patient underwent upper endoscopic ultrasound with fine-needle aspiration which confirmed low-grade GIST.

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Gastrointestinal Bleeding Is an Independent Risk Factor for Poor Prognosis in GIST Patients

Cited by 34 publications

References 20 publications

Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal Tumors (GIST)

Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal Tumors (GIST)

The prognostic value of gender in gastric gastrointestinal stromal tumors: A propensity score matching analysis.

Recent Anti-platelet Therapy Revealing Underlying Undiagnosed Gastrointestinal Stromal Tumor in Otherwise Healthy Patient

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