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Preoperative Predictive Factors for Gastrointestinal Stromal Tumors: Analysis of 375 Surgically Resected Gastric Subepithelial Tumors

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Gastrointestinal stromal tumors (GISTs) and non-GIST subepithelial tumors (SETs) account for about 75 and 25 % of gastric hypoechoic SETs ≥2 cm, respectively. Therefore, identifying preoperative predictive factors for GISTs are required to refine surgical indications.

Methods

We performed a retrospective review of 375 surgically resected gastric hypoechoic SETs ≥2 cm. Demographic data and tumor characteristics based on upper endoscopy and CT findings were compared between GIST and non-GIST SETs originating from muscularis propria layer (leiomyomas, Schwannomas, glomus tumors, and ectopic pancreas).

Results

In cardia, leiomyomas were found twice more frequently than GISTs (63.6 versus 31.8 %). Perilesional lymph node enlargement (PLNE) was found only in patients with GIST or Schwannomas. Patients with GIST showed a significantly lower rate of PLNE than those with Schwannomas (3.5 versus 29.0 %). In multivariate analysis, tumor site outside cardia (odds ratio, 9.157), absence of PLNE (odds ratio, 11.519), old age, large tumor size, exophytic growth pattern, and ulceration or dimpling were identified as independent preoperative predictive factors for GISTs versus non-GIST SETs.

Conclusions

The effort for preoperative pathologic diagnosis such as endosonography-guided tissue sampling might be positively considered for SETs at cardia and SETs with PLNE where the possibility of GIST is low.

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Authors and Affiliations

  1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea

    Yang Won Min, Ha Na Park & Byung-Hoon Min

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Dongil Choi

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Kyoung-Mee Kim

  4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Sung Kim

Authors
  1. Yang Won Min
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  2. Ha Na Park
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  3. Byung-Hoon Min
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  4. Dongil Choi
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  5. Kyoung-Mee Kim
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  6. Sung Kim
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Corresponding author

Correspondence to Byung-Hoon Min.

Additional information

The first two authors (Yang Won Min and Ha Na Park) contributed equally to this work.

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Min, Y.W., Park, H.N., Min, BH. et al. Preoperative Predictive Factors for Gastrointestinal Stromal Tumors: Analysis of 375 Surgically Resected Gastric Subepithelial Tumors. J Gastrointest Surg 19, 631–638 (2015). https://doi.org/10.1007/s11605-014-2708-9

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  • DOI: https://doi.org/10.1007/s11605-014-2708-9

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