Abstract
Purpose
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract arising from Cajal's cells and expressing c-kit. In a consensus report, the clinical behavior of GISTs was categorized into risk classes according to the tumor size and mitotic count. We analyzed the risk categories based on GIST patients who underwent a surgical resection at our institute during a period of 15 years.
Methods
We evaluated the risk categories of GISTs and analyzed the outcome and risk categories retrospectively. We presented the MIB-1 score of the tumor instead of mitotic counts for the evaluation of cellular growth because of inaccuracies regarding the mitotic counts.
Results
Patients were classified into 4 cases of very low risk, 11 of low risk, 8 of intermediate risk, and 5 of high risk. Four high-risk patients showed recurrence as either liver metastasis or peritoneal dissemination. In addition, local recurrence occurred in one low-risk and one intermediate-risk patient each.
Conclusion
Our cases confirmed the correlation between the risk categories and the prognosis. A complete resection with sufficient margin must be confirmed even in low-risk cases to prevent local recurrence. Since high-risk patients showed poor prognosis, the adjuvant treatment with chemotherapeutic regimens must therefore be further studied for high-risk patients.
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References
C Fletcher J Berman C Corless F Gorstein J Lasota BJ Longley et al. (2002) ArticleTitleDiagnosis of gastrointestinal stromal tumors: a consensus approach Hum Pathol 33 459–65 Occurrence Handle12094370 Occurrence Handle10.1053/hupa.2002.123545
I Judson (2002) ArticleTitleGastrointestinal stromal tumours (GIST): biology and treatment Ann Oncol 13 287–9 Occurrence Handle12401703
JY Blay S Bonvalot P Casali H Choi M Debiec-Richter AP Dei Tos et al. (2005) ArticleTitleGIST consensus meeting panelists: Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20–21 March 2004, under the auspices of ESMO Ann Oncol 16 566–78 Occurrence Handle15781488 Occurrence Handle10.1093/annonc/mdi127
M Miettinen W El-Rifai LH Sobin J Lasota (2002) ArticleTitleEvaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review Hum Pathol 33 478–83 Occurrence Handle12094372 Occurrence Handle10.1053/hupa.2002.124123 Occurrence Handle1:CAS:528:DC%2BD38XlslCls7o%3D
T Hasegawa Y Matsuno T Shimoda S Hirohashi (2002) ArticleTitleGastrointestinal stromal tumor: Consistent CD117 immunostaining for diagnosis, and prognostic classification based on tumor size and MIB-1 grade Hum Pathol 33 669–76 Occurrence Handle12152168 Occurrence Handle10.1053/hupa.2002.124116
R Logrono DV Jones S Faruqi MS Bhutani (2004) ArticleTitleRecent advances in cell biology, diagnosis, and therapy of gastrointestinal stromal tumor (GIST) Cancer Biol Ther 3 251–8 Occurrence Handle14726714
N Kosmadakis EE Visvardis P Kartsaklis M Tsimara A Chatziantoniou I Panopoulos et al. (2005) ArticleTitleThe role of surgery in the management of gastrointestinal stromal tumors (GISTs) in the era of imatinib mesylate effectiveness Surg Oncol 14 75–84 Occurrence Handle15993051 Occurrence Handle10.1016/j.suronc.2005.05.002
Z Orosz T Torniczky Z Sapi (2005) ArticleTitleGastrointestinal stromal tumors: a clinicopathologic and immunohistochemical study of 136 cases Pathol Oncol Res 11 11–21 Occurrence Handle15800677 Occurrence Handle10.1007/BF03032400
MH Koay YW Goh B Iacopetta F Grieu A Segal GF Sterrett et al. (2005) ArticleTitleGastrointestinal stromal tumours (GISTs): a clinicopathological and molecular study of 66 cases Pathology 37 22–31 Occurrence Handle15875730 Occurrence Handle10.1080/00313020400023628
M Miettinen LH Sobin J Lasota (2005) ArticleTitleGastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up Am J Surg Pathol 29 52–68 Occurrence Handle15613856 Occurrence Handle10.1097/01.pas.0000146010.92933.de
Y Mochizuki Y Kodera S Ito Y Yamamura Y Kanemitsu Y Shimizu et al. (2004) ArticleTitleTreatment and risk factors for recurrence after curative resection of gastrointestinal stromal tumors of the stomach World J Surg 28 870–5 Occurrence Handle15593459 Occurrence Handle10.1007/s00268-004-7418-0
H Ozguc T Yilmazlar O Yerci R Soylu V Tumay G Filiz et al. (2005) ArticleTitleAnalysis of prognostic and immunohistochemical factors in gastrointestinal stromal tumors with malignant potential J Gastrointest Surg 9 418–29 Occurrence Handle15749606 Occurrence Handle10.1016/j.gassur.2004.07.003
G Tryggvason HG Gislason MK Magnusson JG Jonasson (2005) ArticleTitleGastrointestinal stromal tumors in Iceland, 1990–2003: the Icelandic GIST study, a population-based incidence and pathologic risk stratification study Int J Cancer 117 289–93 Occurrence Handle15900576 Occurrence Handle10.1002/ijc.21167 Occurrence Handle1:CAS:528:DC%2BD2MXhtVygsrfO
T Scholzen J Gerdes (2000) ArticleTitleThe Ki-67 protein: from the known and the unknown J Cell Physiol 182 311–22 Occurrence Handle10653597 Occurrence Handle10.1002/(SICI)1097-4652(200003)182:3<311::AID-JCP1>3.0.CO;2-9 Occurrence Handle1:CAS:528:DC%2BD3cXot1Ggsg%3D%3D
T Aparicio V Boige JC Sabourin P Crenn M Ducreux A Le Cesne et al. (2004) ArticleTitlePrognostic factors after surgery of primary resectable gastrointestinal stromal tumours Eur J Surg Oncol 30 1093–103 Occurrence Handle10.1016/j.ejso.2004.06.016
Y Mochizuki Y Kodera M Fujiwara S Ito Y Yamamura A Sawaki et al. (2006) ArticleTitleLaparoscopic wedge resection for gastrointestinal stromal tumors of the stomach: initial experience Surg Today 36 341–7 Occurrence Handle16554991 Occurrence Handle10.1007/s00595-005-3164-7
J Martin A Poveda A Llombart-Bosch R Ramos JA Lepez-Guerrero J Garcia del Muro et al. (2005) ArticleTitleDeletions affecting codons 557–558 of the c-KIT gene indicate a poor prognosis in patients with completely resected gastrointestinal stromal tumors: a study by the Spanish Group for Sarcoma Research (GEIS) J Clin Oncol 23 6190–8 Occurrence Handle16135486 Occurrence Handle10.1200/JCO.2005.19.554 Occurrence Handle1:CAS:528:DC%2BD2MXhtVKgtbrO
P Rutkowski Z Nowecki P Nyckowski W Dziewirski U Grzesiakowska A Nasierowska-Guttmejer et al. (2006) ArticleTitleSurgical treatment of patients with initially inoperable and/or metastatic gastrointestinal stromal tumors (GIST) during therapy with imatinib mesylate J Surg Oncol 93 304–11 Occurrence Handle16496358 Occurrence Handle10.1002/jso.20466
BL Eisenberg I Judson (2004) ArticleTitleSurgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy Ann Surg Oncol 11 465–75 Occurrence Handle15123459 Occurrence Handle10.1245/ASO.2004.09.011
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Tsukuda, K., Hirai, R., Miyake, T. et al. The Outcome of Gastrointestinal Stromal Tumors (GISTs) After a Surgical Resection in Our Institute. Surg Today 37, 953–957 (2007). https://doi.org/10.1007/s00595-007-3535-3
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DOI: https://doi.org/10.1007/s00595-007-3535-3