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Surgical Therapy for Gastrointestinal Stromal Tumours of the Upper Gastrointestinal Tract

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Aim

This study aimed to examine clinicopathological features and outcomes after primary resection of gastrointestinal stromal tumours (GIST) of the upper gastrointestinal tract

Method

Fifty consecutive patients were identified as having a mesenchymal tumour of the upper gastrointestinal tract resected at our institution, of which 47 were GISTs. The influence of clinicopathological variables on disease-free survival was evaluated using Kaplan–Meier estimates and Cox hazard model.

Results

The median age was 62.8 (21.3–94.7). The commonest presenting symptoms were anaemia (43%) and pain (34%). Tumours were located in the stomach (64%), small bowel (34%) and oesophagus (2%). Median follow-up was 20.4 (2–106) months. Fletcher low/intermediate-risk tumours had a significantly better (p = 0.0008) 2- and 5-year actuarial survival of 100% compared with 88% and 58% for high-risk group. Recurrence-free survival at 2 and 5 years was 100% for low/intermediate-risk group compared with 68% and 45% for the high-risk group (p = 0.0008). Univariate analysis of predictors of recurrence identified male sex, high mitotic rate and tumour size as significant. Multivariate analysis showed high mitotic rate as the only poor prognosticator (Hazard ratio = 16.7, p = 0.02).

Conclusion

Surgical excision of low- and intermediate-grade GIST has an excellent prognosis. Surgery remains the mainstay of treatments, and high-grade tumours carry a significantly worse prognosis. High mitotic rates are an independent poor prognosticator.

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Authors and Affiliations

  1. Departments of Surgery and Gastroenterology, Bankstown Hospital, University of New South Wales, Eldridge Rd, Bankstown, New South Wales, 2200, Australia

    Amitabha Das, Andrew V. Biankin & Neil D. Merrett

  2. Department of Surgery, Liverpool Hospital, Elizabeth St Liverpool, Sydney, New South Wales, 2170, Australia

    Robert Wilson & Neil D. Merrett

  3. Cancer Research Programme, Garvan Institute of Medical Research, 384 Victoria St. Darlinghurst, Sydney, New South Wales, 2010, Australia

    Andrew V. Biankin & Neil D. Merrett

  4. Upper GI Surgery, Sydney Southwest Area Health Service, Bankstown Hospital, Eldridge Rd, Bankstown, New South Wales, 2200, Australia

    Neil D. Merrett

Authors
  1. Amitabha Das
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Correspondence to Neil D. Merrett.

Additional information

Presentation: This work has not been presentedDisclaimers: The authors indicated no potential conflicts of interest Grant Support: None Note all graphs produced using StatView statistical software and further edited with Adobe Photoshop.

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Das, A., Wilson, R., Biankin, A.V. et al. Surgical Therapy for Gastrointestinal Stromal Tumours of the Upper Gastrointestinal Tract. J Gastrointest Surg 13, 1220–1225 (2009). https://doi.org/10.1007/s11605-009-0885-8

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  • DOI: https://doi.org/10.1007/s11605-009-0885-8

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