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World Journal of Surgery

, Volume 32, Issue 11, pp 2375–2382 | Cite as

Surgical Margin Status and Prognosis of Gastrointestinal Stromal Tumor

  • António M. Gouveia
  • Amadeu P. Pimenta
  • Ana F. Capelinha
  • Dionísio de la Cruz
  • Paula Silva
  • José M. Lopes
Article

Abstract

Background

Surgery is the best treatment for primary GIST and may be curative, but resection extension/completeness impact on the prognosis remains controversial. The authors aim was to evaluate the clinicopathological (CP) parameters and surgical margins status influence on GIST patients’ outcome.

Materials and methods

The study evaluated 113 consecutive patients with sporadic GIST; the influence of CP parameters on recurrence-free survival (RFS) and disease-specific survival (DSS) was determined by univariate analysis (UA) and multivariate analysis (MA).

Results

Of 104 cases, macroscopically complete resection was achieved in 96: R0 surgical margin status in 78 and R1 in 18. Recurrence rates (12.5%) were significantly lower in R0 (9.0%) than in R1 (27.8%). Tumor >10 cm, mitotic count >5/50 high power field (HPF), and high-risk GIST predicted poor RFS and DSS (UA). Disease-specific survival was significantly shorter after macroscopic incomplete (R2) resection, for mixed cellular morphology, and in tumors with necrosis (UA). High-risk GIST (p = 0.016) and R2 resection (p = 0.013) predicted poor DSS of patients (MA).

Conclusions

High risk and positive macroscopic surgical margin status are parameters associated with poor disease-specific survival in GIST patients.

Keywords

Overall Survival Imatinib Gastrointestinal Stromal Tumor Gist Patient Tumor Rupture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This work was supported in part by Novartis Oncology, Portugal.

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Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • António M. Gouveia
    • 1
    • 2
  • Amadeu P. Pimenta
    • 1
    • 2
  • Ana F. Capelinha
    • 3
  • Dionísio de la Cruz
    • 3
  • Paula Silva
    • 2
    • 3
  • José M. Lopes
    • 2
    • 3
  1. 1.Department of SurgeryHospital de S. João/Porto Medical SchoolPortoPortugal
  2. 2.Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)PortoPortugal
  3. 3.Department of PathologyHospital de S. João/Porto Medical SchoolPortoPortugal

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