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Treatment and Risk Factors for Recurrence after Curative Resection of Gastrointestinal Stromal Tumors of the Stomach

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Abstract

The current definitive treatment for gastrointestinal stromal tumor (GIST) of the stomach is complete resection. GIST has a highly variable clinical course, and recurrent disease sometimes develops despite curative treatment. Although several known risk factors for recurrence exist, adequate treatment strategies are lacking. This study evaluated factors associated with relapse after curative treatment. Sixty patients with gastric GIST were identified from a hospital disease registry database. Clinicopathologic characteristics of these patients were reviewed and the Cox proportional hazards regression analysis was used to identify recurrent risk factors. With a median follow-up of 60 months (range 5–286 months), recurrence occurred in eight (13%) patients, three of whom underwent resection of the recurrent disease and are alive to date. Univariate analysis demonstrated that invasion of the adjacent organs (p = 0.0005), tumor size (p = 0.0046), and expression of proliferative markers [MIB-1 proliferative index (PI) ≥ 10%] (p = 0.0001) were significant risk factors for recurrence. Multivariate analysis with these three factors as variables revealed that only MIB-1 PI was a significant independent risk factor for recurrence (p = 0.0051). In conclusion, surgical resection may be indicated whenever a recurrent GIST is considered resectable. A high MIB-1 PI was identified as an independent indicator of risk for recurrent disease following curative surgery.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, 464-8681, Nagoya, Japan

    Yoshinari Mochizuki M.D., Seiji Ito M.D., Yoshitaka Yamamura M.D., Yukihide Kanemitsu M.D., Yasuhiro Shimizu M.D., Takashi Hirai M.D., Kenzo Yasui M.D. & Tomoyuki Kato M.D.

  2. Department of Surgery II, Nagoya University School of Medicine, 65, Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan

    Yasuhiro Kodera M.D.

  3. Division of Oncological Pathology, Aichi Cancer Center Research Institute, 1-1, Kanokoden, Chikusa-ku, 464-8681, Nagoya, Japan

    Ken-ichi Inada M.D.

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  1. Yoshinari Mochizuki M.D.
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  2. Yasuhiro Kodera M.D.
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  6. Yasuhiro Shimizu M.D.
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  8. Kenzo Yasui M.D.
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  9. Ken-ichi Inada M.D.
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  10. Tomoyuki Kato M.D.
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Correspondence to Yasuhiro Kodera M.D..

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Mochizuki, Y., Kodera, Y., Ito, S. et al. Treatment and Risk Factors for Recurrence after Curative Resection of Gastrointestinal Stromal Tumors of the Stomach. World J. Surg. 28, 870–875 (2004). https://doi.org/10.1007/s00268-004-7418-0

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