Validation of the Joensuu risk criteria for primary resectable gastrointestinal stromal tumour – The impact of tumour rupture on patient outcomes

Rutkowski, Piotr; Bylina, Elżbieta; Woźniak, Agnieszka; Nowecki, Zbigniew; Osuch, Czesław; Matłok, Maciej; Świtaj, Tomasz; Michej, Wanda; Wroński, Marek; Głuszek, Stanisław; Kroc, J.; Nasierowska‐Guttmejer, Anna; Joensuu, Heikki

doi:10.1016/j.ejso.2011.06.005

Cited by 153 publications

(119 citation statements)

References 23 publications

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“…Among risk-stratification tools, the most widely used are the Armed Forces Institute of Pathology (AFIP) classification (8) and the modified NIH consensus (9). Primary tumor size, mitotic count, and tumor site are well-established risk factors for disease-free survival (DFS); tumor rupture has later been associated with the higher risk of relapse (9,10). Moreover, in the last years the potential role of mutational status as a prognostic factor has been examined in a number of retrospective studies.…”

Section: Introductionmentioning

confidence: 99%

Tumor Genotype Is an Independent Prognostic Factor in Primary Gastrointestinal Stromal Tumors of Gastric Origin: A European Multicenter Analysis Based on ConticaGIST

Woźniak

Rutkowski

Schöffski

et al. 2014

Clinical Cancer Research

133

107

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Purpose: Although the mutational status in gastrointestinal stromal tumors (GIST) can predict the response to treatment with tyrosine kinase inhibitors, the role of tumor genotype as a prognostic factor remains controversial. The ConticaGIST study sought to determine the pathologic and molecular factors associated with disease-free survival (DFS) in patients with operable, imatinib-naive GIST.Experimental Design: Clinicopathologic and molecular data from 1,056 patients with localized GIST who underwent surgery with curative intention (R0/R1) and were registered in the European ConticaGIST database were prospectively obtained and reviewed. Risk of tumor recurrence was stratified using the modified NIH criteria. The median follow-up was 52 months.Results: On testing for potential prognostic parameters, the following were associated with inferior DFS on multivariable Cox model analysis: primary nongastric site, size >10 cm, mitotic index >10 mitoses per 50 high power field, and the KIT exon 9 duplication [hazard ratio (HR), 1.47; 95% confidence interval (CI), 0.9-2.5; P ¼ 0.037] and KIT exon 11 deletions involving codons 557 and/or 558 [KITdel-inc557/558; HR, 1.45; 95% CI, 1.0-2.2; P ¼ 0.004]. Conversely, PDGFRA exon 18 mutations were indicators of better prognosis [HR, 0.23; 95% CI, 0.1-0.6; P ¼ 0.002]. KITdel-inc557/558 were an adverse indicator only in GIST localized in the stomach (P < 0.001) but not in tumors with nongastric origin. In gastric GIST, all other mutations presented remarkably superior 5-year DFS.Conclusions: In conclusion, tumor genotype is an independent molecular prognostic variable associated with gastric GIST and should be used for optimizing tailored adjuvant imatinib treatment.

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Section: Introductionmentioning

confidence: 99%

Tumor Genotype Is an Independent Prognostic Factor in Primary Gastrointestinal Stromal Tumors of Gastric Origin: A European Multicenter Analysis Based on ConticaGIST

Woźniak

Rutkowski

Schöffski

et al. 2014

Clinical Cancer Research

133

107

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“…The Armed Forces Institute of Pathology Criteria (AFIPC) use tumor location in addition to size and mitotic count [4]. The Joensuu modified NIH classification (J-NIHC) combines the advantages of the NIHC and AFIPC with the additional factor of rupture [17]. The American Joint Committee on Cancer staging system (AJCCS) uses the TNM classification.…”

Section: Introductionmentioning

confidence: 99%

Re-appraisal of risk classifications for primary gastrointestinal stromal tumors (GISTs) after complete resection: indications for adjuvant therapy

et al. 2014

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Background A substantial number of localized gastrointestinal stromal tumor (GIST) patients have recurrences even after complete resection. The risk of recurrence after complete resection should be estimated when considering adjuvant therapy. In this study, we evaluated prognostic factors of GIST recurrence and compared several reported risk-stratification schemes for defining risk of recurrence to guide the use of adjuvant therapy using data from a large Japanese GIST population. Methods We analyzed clinicopathological data collected retrospectively and prospectively from 712 GISTs with complete resection from 1980-2010. We evaluated possible prognostic factors and compared the National Institutes of Health consensus criteria, the Armed Forces Institute of Pathology criteria, Joensuu's modified NIH classification (J-NIHC), the American Joint Committee on Cancer staging system (AJCCS), and the Japanese modified NIH criteria for prediction of tumor recurrence in adjuvant settings. Results Univariate analysis suggested that the following factors were prognostic: tumor size, mitotic count, site, clinically malignant features of rupture and/or invasion, and gender. In multivariate analysis, size [5 cm, mitotic count [5/50 HPF, non-gastric location, and the presence of rupture and/or macroscopic invasion were independent adverse prognostic factors. When adjuvant therapy is considered for patients with high-risk GIST, the J-NIHC was the most sensitive classification system, while the AJCCS appeared to be the most accurate for predicting recurrence. Conclusion Tumor size, mitotic count, tumor site, and clinical features of rupture and/or invasion were important prognostic factors for GIST recurrence. Joensuu's classification appeared to best identify candidates for adjuvant therapy.

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“…Similar clinical symptoms can be caused by many different gastric tumors, especially usual cancers.IntheexperienceofthePolishGastrointestinal TumorWorkingGroupbleedingfromulceratedgastricGISTsorrupturedGISTsisafrequentandtypical complication in clinical outcomes [6,7]. Like other pastcasesofGISTs,thepresentcaseproceededwith massivegastricbleedingandrequiredanurgentlaparotomywithlocaltumorresection.Rarely,described cases of gastric bleeding are complex and might be connectedwithanothertypesofgastrictumorsbesides GISTsorGDCoccurringincidentally,simultaneously also with other kind of cancer.…”

Section: Discussionmentioning

confidence: 97%

Gastric gastrointestinal stromal tumor with incomplete duplication cyst – a case with possibility of neoplasia in fetal-period malformed tissues

Lewitowicz¹,

Matykiewicz²,

Kozieł³

et al. 2015

pjp

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ThecoincidenceofGISTandothergastricmalignanciesaredocumentedwellbut arisingGISTfromcongenitalanomaliesisstillrarityinliterature.Todate,only a few papers have been concerned on the possibility of arising neoplasms from duplicationcystofgastrointestinaltract.There,aredominatingusualcancers,neuroendocrinecancersorlymphomasbutGISThasbeennotedonlyonce.Here,we report a case of 73 years old female-patient with typical gastric stromal tumor comprisedcentrallylockedanincompleteduplicationcyst.

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Validation of the Joensuu risk criteria for primary resectable gastrointestinal stromal tumour – The impact of tumour rupture on patient outcomes

Cited by 153 publications

References 23 publications

Tumor Genotype Is an Independent Prognostic Factor in Primary Gastrointestinal Stromal Tumors of Gastric Origin: A European Multicenter Analysis Based on ConticaGIST

Tumor Genotype Is an Independent Prognostic Factor in Primary Gastrointestinal Stromal Tumors of Gastric Origin: A European Multicenter Analysis Based on ConticaGIST

Re-appraisal of risk classifications for primary gastrointestinal stromal tumors (GISTs) after complete resection: indications for adjuvant therapy

Gastric gastrointestinal stromal tumor with incomplete duplication cyst – a case with possibility of neoplasia in fetal-period malformed tissues

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