Factors Affecting Disease-Free Survival in Operated Nonmetastatic Gastrointestinal Stromal Tumors.
Adult
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
/ statistics & numerical data
Colon
/ pathology
Digestive System Surgical Procedures
Disease-Free Survival
Female
Follow-Up Studies
Gastrointestinal Neoplasms
/ genetics
Gastrointestinal Stromal Tumors
/ genetics
Humans
Intestine, Small
/ pathology
Kaplan-Meier Estimate
Male
Middle Aged
Patient Selection
Proto-Oncogene Proteins c-kit
/ genetics
Rectum
/ pathology
Retroperitoneal Space
/ pathology
Retrospective Studies
Risk Assessment
Risk Factors
Stomach
/ pathology
Young Adult
Disease-free survival
Gastrointestinal stromal tumor
Imatinib
Overall survival
Journal
The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
24
01
2019
revised:
09
03
2019
accepted:
22
03
2019
pubmed:
27
4
2019
medline:
15
2
2020
entrez:
27
4
2019
Statut:
ppublish
Résumé
Possibly originating from interstitial Cajal cells, gastrointestinal stromal tumors (GISTs) have variable biological behaviors. In this study, we aimed to examine the factors affecting the disease-free survival (DFS) in patients with GIST who underwent operation. The study included the patients who were followed up and treated for GIST in our oncology clinic between 2002 and 2017. The Armed Forces Institute of Pathology criteria (Miettinen risk score) were used for risk stratification of patients. Seventy-four patients were included to the study, where female patients constituted 52.7%, and the median age was 56 (range: 24-83) y. Most common primary tumor location was the stomach (51.4%), followed by the small intestine (33.8%), colorectum (10.8%), and retroperitoneum (4.1%). Miettinen risk score showed 12 patients (16.7%) at very low risk, 15 patients (20.8%) at low risk, 18 patients (25%) at intermediate risk, and 27 patients (37.5%) at high risk. DFS was significantly lower in patients with small intestine involvement than in cases with stomach involvement (P = 0.004). DFS was significantly lower in patients at high risk than in patients with no high risk (P = 0.034). Small intestine localization (hazard ratio [HR], 8.98; 95% confidence interval [CI], 1.14-8.18), high-risk score (HR, 5.16; 95% CI, 1.42-12.75), c-kit positivity (HR, 0.24; 95% CI, 0.13-0.69), and adjuvant therapy (HR, 0.37; 95% CI, 0.20-0.92) were found to be the most significant factors affecting DFS. Our study showed negative effects of small intestine localization and high-risk category and positive effects of c-kit positivity and adjuvant therapy on DFS in patients with GIST who underwent operation. When a decision will be made in favor of adjuvant therapy, tumor localization and c-kit mutation should also be considered in addition to risk score.
Sections du résumé
BACKGROUND
Possibly originating from interstitial Cajal cells, gastrointestinal stromal tumors (GISTs) have variable biological behaviors. In this study, we aimed to examine the factors affecting the disease-free survival (DFS) in patients with GIST who underwent operation.
MATERIAL AND METHODS
The study included the patients who were followed up and treated for GIST in our oncology clinic between 2002 and 2017. The Armed Forces Institute of Pathology criteria (Miettinen risk score) were used for risk stratification of patients.
RESULTS
Seventy-four patients were included to the study, where female patients constituted 52.7%, and the median age was 56 (range: 24-83) y. Most common primary tumor location was the stomach (51.4%), followed by the small intestine (33.8%), colorectum (10.8%), and retroperitoneum (4.1%). Miettinen risk score showed 12 patients (16.7%) at very low risk, 15 patients (20.8%) at low risk, 18 patients (25%) at intermediate risk, and 27 patients (37.5%) at high risk. DFS was significantly lower in patients with small intestine involvement than in cases with stomach involvement (P = 0.004). DFS was significantly lower in patients at high risk than in patients with no high risk (P = 0.034). Small intestine localization (hazard ratio [HR], 8.98; 95% confidence interval [CI], 1.14-8.18), high-risk score (HR, 5.16; 95% CI, 1.42-12.75), c-kit positivity (HR, 0.24; 95% CI, 0.13-0.69), and adjuvant therapy (HR, 0.37; 95% CI, 0.20-0.92) were found to be the most significant factors affecting DFS.
CONCLUSIONS
Our study showed negative effects of small intestine localization and high-risk category and positive effects of c-kit positivity and adjuvant therapy on DFS in patients with GIST who underwent operation. When a decision will be made in favor of adjuvant therapy, tumor localization and c-kit mutation should also be considered in addition to risk score.
Identifiants
pubmed: 31026795
pii: S0022-4804(19)30175-1
doi: 10.1016/j.jss.2019.03.059
pii:
doi:
Substances chimiques
KIT protein, human
EC 2.7.10.1
Proto-Oncogene Proteins c-kit
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
170-177Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.