Abstract
BackgroundAlthough the clinical benefit of imatinib adjuvant therapy for high-risk patients with gastrointestinal stromal tumor (GIST) has been proven, the recurrence rate still remains high. This study aimed to sub-divide high-risk GIST patients with some “very high-risk” factors for more precise prognostic indicator, and possible association with efficiency of imatinib adjuvant therapy.MethodsClinicopathological data were confirmed by pathological diagnosis and clinical records. Recurrence-free survivals (RFS) were evaluated in 370 GIST patients (212 cases as test cohort and 158 cases as validation cohort) and 48 high-risk GISTs with imatinib adjuvant therapy after R0 resection.ResultsMitosis count > 10/50 high-power fields (HPF) and serosal invasion are independent prognostic factors for RFS of GIST patients. Mitosis count > 10/50HPF and serosal invasion can sub-divide high-risk GIST patients effectively and significantly improve the area under the curve (AUC) of receiver operating characteristics (ROC) curve for prognostic indicator both in test and validation cohort. Patients with serosal invasion after R0 resection showed a poorer prognosis with imatinib adjuvant therapy.ConclusionsSub-division of high-risk GIST patients helps to more precisely predicting the prognosis. Serosal invasion may be an adverse predictive factor in high-risk patients and imatinib treatment outcome.
Highlights
The clinical benefit of imatinib adjuvant therapy for high-risk patients with gastrointestinal stromal tumor (GIST) has been proven, the recurrence rate still remains high
Mitosis count > 10/50HPF and serosal invasion are independent prognostic factors for recurrence-free survival of GIST patients Characteristics of GIST patients in test and validation cohort were shown in Table 1, chi-squared tests showed there were no differences between the test and validation cohorts in reported variables
Univariate analysis showed that tumor size (≤10, > 10 cm), mitosis count (≤10, > 10/50 high-power fields (HPF)) and serosal invasion were prognostic predictors for Recurrence-free survivals (RFS) both in the test and validation cohort
Summary
The clinical benefit of imatinib adjuvant therapy for high-risk patients with gastrointestinal stromal tumor (GIST) has been proven, the recurrence rate still remains high. This study aimed to sub-divide high-risk GIST patients with some “very high-risk” factors for more precise prognostic indicator, and possible association with efficiency of imatinib adjuvant therapy. Gastrointestinal stromal tumor (GIST) accounts for more than 80% of all gastrointestinal mesenchymal tumors [1] As it ranks below only gastric and colorectal cancers, GIST is among the most common types of gastrointestinal tumors. The clinical behaviors and the outcomes of GIST still vary even in the same group of the risk, especially in the patients with high-risk of recurrence. The recurrence and metastasis rates, especially for the patients at highrisk stage, remain high [8,9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
