Prognostic Analysis of Duodenal Gastrointestinal Stromal Tumors.

Liwen Hong,Jie Zhong,Yun Lin,Rong Fan,Mengmeng Cheng,Zhengting Wang,Peijun Sun,Qiangqiang Wu,Xiaolin Zhou,Tianyu Zhang,Juntao Sun,Lei Wang,Maochen Zhang

doi:10.1155/2018/4812703

Abstract

Aim This study aims to analyze factors possibly related to the prognosis of duodenal gastrointestinal stromal tumors (DGISTs). Methods We collected and retrospectively analyzed clinical and pathological data of 62 patients with primary DGISTs. All the patients were hospitalized and received complete surgical resection at Shanghai Ruijin Hospital from September 2003 to April 2015. We followed up the patients to determine survival outcomes. We also analyzed the effect of clinical and pathological factors on disease-free survival (DFS) and overall survival (OS) of the patients. Results Kaplan-Meier univariate survival analysis demonstrated that tumor size, mitotic index, Ki-67 index, and pathological risk were correlated with the DFS and OS of the patients (DFS P = 0.039, 0.001, <0.001, and 0.005, resp.; OS P = 0.027, 0.007, <0.001, and 0.012, resp.). Cox multivariate regression analysis revealed that Ki-67 index was an independent prognostic factor affecting DFS and OS (P = 0.007 and 0.028, resp.). Moreover, Kaplan-Meier survival analysis showed that imatinib treatment for patients with recurrence was correlated with prolonged OS (P = 0.002). Conclusion Prognosis for DGIST treated by R0 resection is favorable. High level of Ki-67 can be an independent risk factor of DGIST prognosis. Adjuvant imatinib therapy for patients with tumor recurrence could probably lead to prolonged survival.

Highlights

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract
We focus on several potential factors, such as clinicopathological parameters and imatinib treatment, to predict disease-free survival (DFS) and overall survival (OS) of 62 patients with duodenal GISTs (DGISTs)
DGISTs primarily occurred in the descending duodenum (49.09%), followed by the horizontal duodenum (38.18%), duodenum bulb (10.91%), and ascending duodenum (1.82%)

Summary

Introduction

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Gastric GISTs (60%) and intestinal GISTs (30%) are the most common types, whereas duodenal GISTs (DGISTs) are rare (5%) [1]. The prognosis of GISTs is correlated with tumor site, tumor size, mitotic count, and Ki-67 expression [2, 3]. Despite increasing studies on DGISTs, prognostic analyses remain limited because of the rarity of these tumors. In this retrospective study, we focus on several potential factors, such as clinicopathological parameters and imatinib treatment, to predict disease-free survival (DFS) and overall survival (OS) of 62 patients with DGISTs

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