Two staging systems for gastrointestinal stromal tumors in the stomach: which is better?

Dae Hwan Kim,Bong Eun Lee,Gwang Ha Kim,Do Youn Park,Tae Yong Jeon,Kyung Un Choi,Chul Hong Park,Geun Am Song

doi:10.1186/s12876-017-0705-7

Abstract

BackgroundThe prognosis of a gastrointestinal stromal tumor (GIST) is influenced by its anatomic site; however, few studies on the prognosis of gastric GISTs have been reported. The aims of this study were to evaluate long-term prognoses of patients who underwent surgical resection for gastric GISTs and to compare the clinical efficacy of two staging systems: the National Institutes of Health (NIH) consensus criteria and the 7th Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) tumor-node-metastasis (TNM) staging system.MethodsWe conducted a retrospective observational study of 145 patients who underwent surgical resection for gastric GISTs between February 2001 and June 2012 at Pusan National University Hospital (Busan, Korea). Recurrence and 5-year recurrence-free survival (RFS) rates were analyzed.ResultsDuring a median follow-up period of 44 months (range, 6–144 months), 11 recurrent lesions were detected in 9 patients (6.4%). On multivariate analysis, tumor size (>5 cm), mitotic count (>5/50 high-power fields), and epithelioid and mixed pathological type were significantly associated with recurrence. The overall 5-year RFS rate was 93.4%. Although no statistically significant differences were detected (C-statistic difference P = 0.886), all metrics showed lower values for the UICC/AJCC TNM staging system than for the NIH consensus criteria, suggesting that the UICC/AJCC TNM staging system may be a better model.ConclusionsThe 5-year RFS rate in patients who underwent curative resection for gastric GISTs was excellent. The UICC/AJCC TNM staging system may be more useful than the NIH consensus criteria for risk categorization of patients with gastric GISTs.

Highlights

The prognosis of a gastrointestinal stromal tumor (GIST) is influenced by its anatomic site; few studies on the prognosis of gastric Gastrointestinal stromal tumors (GISTs) have been reported
Complete resection was achieved in 144 patients (99.3%); only one case had a ruptured GIST at the time of diagnosis
Many previous studies have reported the clinical outcomes of GISTs, few studies have focused on gastric GISTs alone

Summary

Introduction

The prognosis of a gastrointestinal stromal tumor (GIST) is influenced by its anatomic site; few studies on the prognosis of gastric GISTs have been reported. The aims of this study were to evaluate long-term prognoses of patients who underwent surgical resection for gastric GISTs and to compare the clinical efficacy of two staging systems: the National Institutes of Health (NIH) consensus criteria and the 7th Union for International Cancer Control/American Joint Committee on Cancer (UICC/ AJCC) tumor-node-metastasis (TNM) staging system. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs can occur anywhere along the gastrointestinal tract. The most common site is GISTs are characterized by a diverse spectrum of morphological and clinical features ranging from benign to malignant. The primary treatment for localized GISTs is complete surgical resection with microscopic negative margins. Metastatic, or recurrent GISTs can be treated with

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