Skip to main content
SpringerLink
Log in

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

  • Research Article
  • Published:
Frontiers of Medicine Aims and scope Submit manuscript

Abstract

In order to find out the potential indicators predicting prognosis of malignant gastrointestinal stromal tumors (GISTs) after surgical resection, we collected clinical records of 80 patients with malignant GISTs. Tumor location, size, mitotic index, necrosis were compared with the prognosis of malignant GISTs by Kaplan-Meier method and log-rank test. After a median follow-up of 844 days (52–2 145), we found that as National Institutes of Health suggested, tumors with intermediate risk had more favorable prognosis than that with high risk. Their 3-year survival rate were 65.3% and 41.3%, respectively (P < 0.001). Moreover, tumor size and mitotic index were associated with free survival. The 3-year survival rate for patients with tumor size ⩽ 10 cm and > 10 cm were 62.3% and 41.8%, respectively (P = 0.002), Tumors with mitotic index ⩽ 5/50 HPF had a higher 3-year survival rate than tumors with mitotic index > 5/50 HPF (67.1% versus 40.7%, P = 0.005). The presence of necrosis was directly related to the malignant behavior. The 3-year survival rate for presence and absence necrosis were 50.8% and 64.8% (P = 0.008). From the present study, we can conclude that besides tumors size and mitotic index, tumor location and necrosis also influence on the long-term survival of patient with malignant GISTs after surgical resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zabka J. Gastrointestinal stromal tumors. Klin Onkol 2011; 24(3): 187–194 (in Czech)

    PubMed  CAS  Google Scholar 

  2. Liu SL, Song ZF, Li W, Liu XW, Zhang C, Zheng QC. A clinicopathologic andimmunohistochemical study of gastrointestinal stromal tumors based on 122 cases. Chinese-German J Clin Oncol 2010; 9(10): 597–600

    Article  Google Scholar 

  3. Hirota S, Isozaki K. Pathology of gastrointestinal stromal tumors. Pathol Int 2006; 56(1): 1–9

    Article  PubMed  CAS  Google Scholar 

  4. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998; 279(5350): 577–580

    Article  PubMed  CAS  Google Scholar 

  5. Heinrich MC, Corless CL, Duensing A, McGreevey L, Chen CJ, Joseph N, Singer S, Griffith DJ, Haley A, Town A, Demetri GD, Fletcher CD, Fletcher JA. PDGFRA activating mutations in gastrointestinal stromal tumors. Science 2003; 299(5607): 708–710

    Article  PubMed  CAS  Google Scholar 

  6. Mochizuki Y, Kodera Y, Ito S, Yamamura Y, Kanemitsu Y, Shimizu Y, Hirai T, Yasui K, Inada K, Kato T. Treatment and risk factors for recurrence after curative resection of gastrointestinal stromal tumors of the stomach. World J Surg 2004; 28(9): 870–875

    Article  PubMed  Google Scholar 

  7. Keun Park C, Lee EJ, Kim M, Lim HY, Choi DI, Noh JH, Sohn TS, Kim S, Kim MJ, Lee HK, Kim KM. Prognostic stratification of high-risk gastrointestinal stromal tumors in the era of targeted therapy. Ann Surg 2008; 247(6): 1011–1018

    Article  PubMed  Google Scholar 

  8. Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in pre-imatinib mesylate era. Cancer 2005; 103(4): 821–829

    Article  PubMed  Google Scholar 

  9. Bertolini V, Chiaravalli AM, Klersy C, Placidi C, Marchet S, Boni L, Capella C. Gastrointestinal stromal tumors—frequency, malignancy, and new prognostic factors: the experience of a single institution. Pathol Res Pract 2008; 204(4): 219–233

    Article  PubMed  Google Scholar 

  10. Miettinen M, El-Rifai W, Sobin LH, Lasota J. Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum Pathol 2002; 33(5): 478–483

    Article  PubMed  Google Scholar 

  11. Tryggvason G, Kristmundsson P, Örvar K, Jónasson JG, Magnússon MK, Gíslason HG. Clinical study on gastrointestinal stromal tumors (GIST) in Iceland, 1990–2003. Dig Dis Sci 2007; 52(9): 2249–2253

    Article  PubMed  Google Scholar 

  12. Gold JS, Dematteo RP. Combined surgical and molecular therapy: the gastrointestinal stromal tumor model. Ann Surg 2006; 244(2): 176–184

    Article  PubMed  Google Scholar 

  13. Kontogianni-Katsarou K, Lariou C, Tsompanaki E, Vourlakou C, Kairi-Vassilatou E, Mastoris C, Pantazi G, Kondi-Pafiti A. KITnegative gastrointestinal stromal tumors with a long term follow-up: a new subgroup does exist. World J Gastroenterol 2007; 13(7): 1098–1102

    PubMed  Google Scholar 

  14. Casali PG, Blay JY. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21(Suppl 5): v98–v102

    Article  PubMed  Google Scholar 

  15. Yamamoto H, Kojima A, Miyasaka Y, Imamura M, Nakamura N, Yao T, Tsuneyoshi M, Oda Y. Prognostic impact of blood vessel invasion in gastrointestinal stromal tumor of the stomach. Hum Pathol 2010; 41(10): 1422–1430

    Article  PubMed  Google Scholar 

  16. Greenson JK. Gastrointestinal stromal tumors and other mesenchymal lesions of the gut. Mod Pathol 2003; 16(4): 366–375

    Article  PubMed  Google Scholar 

  17. Dirnhofer S, Leyvraz S. Current standards and progress in understanding and treatment of GIST. Swiss Med Wkly 2009; 139(7–8): 90–102

    PubMed  Google Scholar 

  18. Hassan I, You YN, Shyyan R, Dozois EJ, Smyrk TC, Okuno SH, Schleck CD, Hodge DO, Donohue JH. Surgically managed gastrointestinal stromal tumors: a comparative and prognostic analysis. Ann Surg Oncol 2008; 15(1): 52–59

    Article  PubMed  Google Scholar 

  19. Haller F, Happel N, Schulten HJ, von Heydebreck A, Schwager S, Armbrust T, Langer C, Gunawan B, Doenecke D, Füzesi L. Sitedependent differential KIT and PDGFRA expression in gastric and intestinal gastrointestinal stromal tumors. Mod Pathol 2007; 20(10): 1103–1111

    Article  PubMed  CAS  Google Scholar 

  20. Miettinen M, Lasota J. Gastrointestinal stromal tumors (GISTs): definition, occurrence, pathology, differential diagnosis and molecular genetics. Pol J Pathol 2003; 54(1): 3–24

    PubMed  Google Scholar 

  21. Hoeben A, Schöffski P, Debiec-Rychter M. Clinical implications of mutational analysis in gastrointestinal stromal tumours. Br J Cancer 2008; 98(4): 684–688

    Article  PubMed  CAS  Google Scholar 

  22. Calabuig-Fariñas S, López-Guerrero JA, Navarro S, Machado I, Poveda A, Pellín A, Llombart-Bosch A. Evaluation of prognostic factors and their capacity to predict biological behavior in gastrointestinal stromal tumors. Int J Surg Pathol 2011; 19(4): 448–461

    Article  PubMed  Google Scholar 

  23. Hueman MT, Schulick RD. Management of gastrointestinal stromal tumors. Surg Clin North Am 2008; 88(3): 599–614, vii

    Article  PubMed  Google Scholar 

  24. Parfitt JR, Streutker CJ, Riddell RH, Driman DK. Gastrointestinal stromal tumors: a contemporary review. Pathol Res Pract 2006; 202(12): 837–847

    Article  PubMed  Google Scholar 

  25. Strickland L, Letson GD, Muro-Cacho CA. Gastrointestinal stromal tumors. Cancer Control 2001; 8(3): 252–261

    PubMed  CAS  Google Scholar 

  26. Sanchez Hidalgo JM, Rufian Peña S, Ciria Bru R, Naranjo Torres A, Muñoz Casares C, Ruiz Rabelo J, Briceño Delgado J. Gastrointestinal stromal tumors (GIST): a prospective evaluation of risk factors and prognostic scores. J Gastrointest Cancer 2010; 41(1): 27–37

    Article  PubMed  Google Scholar 

  27. Blackstein ME, Blay JY, Corless C, Driman DK, Riddell R, Soulières D, Swallow CJ, Verma S. Gastrointestinal stromal tumours: consensus statement on diagnosis and treatment. Can J Gastroenterol 2006; 20(3): 157–163

    PubMed  Google Scholar 

  28. Stratopoulos C, Soonawalla Z, Piris J, Friend PJ. Hepatopancreatoduodenectomy for metastatic duodenal gastrointestinal stromal tumor. Hepatobiliary Pancreat Dis Int 2006; 5(1): 147–150

    PubMed  Google Scholar 

  29. Liu SL, Zheng QC, Song ZF, Li W, Hu SB. Gastrointestinal stromal tumor of duodenum: a cause of upper gastrointestinal hemorrhage. Chinese-German J Clin Oncol 2010; 9(4): 243–245

    Article  Google Scholar 

  30. van der Zwan SM, DeMatteo RP. Gastrointestinal stromal tumor: 5 years later. Cancer 2005; 104(9): 1781–1788

    Article  PubMed  Google Scholar 

  31. Rutkowski P, Nowecki ZI, Michej W, Debiec-Rychter M, Woźniak A, Limon J, Siedlecki J, Grzesiakowska U, Kakol M, Osuch C, Polkowski M, GŁuszek S, Zurawski Z, Ruka W. Risk criteria and prognostic factors for predicting recurrences after resection of primary gastrointestinal stromal tumor. Ann Surg Oncol 2007; 14(7): 2018–2027

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Qinggang Hu, Shanglong Liu, Jianwei Jiang, Chen Zhang, Xiaowei Liu & Qichang Zheng

Authors
  1. Qinggang Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shanglong Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jianwei Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chen Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaowei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qichang Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qichang Zheng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hu, Q., Liu, S., Jiang, J. et al. Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors. Front. Med. 6, 317–321 (2012). https://doi.org/10.1007/s11684-012-0203-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11684-012-0203-9

Keywords

Search

Navigation