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01-09-2019 | 2018 SAGES Oral

Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review

Authors: Zifeng Yang, Xingyu Feng, Peng Zhang, Tao Chen, Haibo Qiu, Zhiwei Zhou, Guoxin Li, Kai Xiong Tao, Yong Li, China Gastrointestinal Stromal Tumor Study Group (CN-GIST)

Published in: Surgical Endoscopy | Issue 9/2019

Abstract

Background

Till present, there are still controversies over the epidemiology, pathological features, types of surgical treatment, and prognoses of primary small gastric GISTs (gGISTs).

Methods

From January 1998 to January 2015, patients with primary small gGIST admitted from four high-volume medical centers of the Southern China were enrolled and their data were analyzed to evaluate their clinicopathological features, treatment and prognostic factors to provide evidence-based medical experience for clinical practice.

Results

A total of 276 primary small gGIST cases over a period of 18 years were investigated and had a median age of 60 years (range 27–91 years old). Regarding the tumor sites, 24 (8.7%) cases were in the cardia of the stomach, 107 (38.8%) in the fundus, 117 (42.4%) in the gastric body, and 28 (10.1%) in the gastric antrum. Eleven patients (4.0%) underwent a preoperative biopsy. A total of 137 (49.6%), 75 (27.2%), and 64 (23.2%) patients underwent laparoscopic, open resection, and endoscopic resection, respectively. Sixty-four patients (23.2%) had local endoscopic resection, 172 (62.3%) had wedge resection, 7 (2.5%) had proximal gastrectomy, 19 (6.9%) had distal gastrectomy, and 14 (5.1%) had total gastrectomy. Mitotic counts were ≤ 5/50, (5–10)/50, and > 10/50 per HPF in 259 (93.8%), 7 (2.5%), and 10 (3.6%) cases, respectively. There were 259 cases (97.1%) of spindle cell type, 7 (2.5%) epithelial cell types and one case (0.4%) of mixed type. Immunohistochemistry showed 74.6% (206/276), 98.2% (271/276), and 97.4% (269/276) of the patients had co-expression of CD34+, CD117+, and DOG-1+, respectively. Thirty-nine patients underwent genetic testing (39/276, 14.1%). Three patients (1.1%) had positive resection margin. Five high-risk patients received follow-up treatment with imatinib with a median follow-up time of 38 months (range 3–156 months). The overall 1-, 3-, and 5-year overall survival rates were 100%, 99.6%, and 99.1%, respectively.

Conclusion

Though the incidence of primary small gGISTs increased per annum, the overall survival prognoses were high. Surgery or endoscopic resection was the primary mode of treatment. Pathological features of primary small gGISTs were similar to large gGISTs, and to achieve a timely surgical intervention, the identification of intermediate- and high-risk cases should be a future focus of study.

Graphical Abstract

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Title: Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review
Authors: Zifeng Yang
Xingyu Feng
Peng Zhang
Tao Chen
Haibo Qiu
Zhiwei Zhou
Guoxin Li
Kai Xiong Tao
Yong Li
China Gastrointestinal Stromal Tumor Study Group (CN-GIST)
Publication date: 01-09-2019
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 9/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6564-7

At a glance: The STEP trials

Springer Medicine

Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review

Abstract

Background

Methods

Results

Conclusion

Graphical Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical Abstract

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