Cox model analysis for multiple factors in prognosis of patients with the primary gastrointestinal stromal tumors

Abstract

Objective To analyze the clinical characteristics,effects of adjuvant therapy and influential factors of gastrointestinal stromal tumors (GIST).Methods A retrospective and multiple factor Cox model analysis on 216 cases of primary GIST diagnosed by surgery and pathology was conducted.Results The total survival rates of patients at one to five years were 94.4 ％ (204/216),90.2 ％ (129/143),88.3 ％(68/77),87.5 ％ (35/40) and 85.0 ％ (17/20),respectively.The statistically significant prognostic factors for survival rates of patients with GIST included age,location of tumor,local or total tumor resection,rupture of tumor,adjuvant treatment,recurrence,mitotic rate,and tumor size (P ＜ 0.05).Due to those influence factors,the greater of the values,the higher of the risk of death.Among those factors,whether having grass total resection played a decisive role in the prognosis of patients with GIST.Other factors,such as sex,CD117,biopsies,endoscopic mucosal erosion,and operation cutting margin had no significant relevance with the survival rate of patients (P ＞0.05).Postoperative adjuvant therapy could significantly improve the survival rate of patients with GIST,especially for patients with high risk.Conclusion Surgical treatment should be given priority to treatment of GIST,and the choice of the surgery strategies depends mainly on the location and size of tumors.The complete resection or extensive resection could improve survival rates.Age,location,total tumor resection,rupture of tumor,adjuvant treatment,recurrence,mitotic rate,and tumor size are important factors affecting prognosis and survival rate of patients with GIST,which could guide standardized clinical treatment. Key words: Gastrointestinal stromal tumors; Risk factors; Prognosis; Proportional hazards models