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01-07-2007 | Gastrointestinal Oncology

Risk Criteria and Prognostic Factors for Predicting Recurrences After Resection of Primary Gastrointestinal Stromal Tumor

Authors: Piotr Rutkowski, MD, PhD, Zbigniew I. Nowecki, MD, PhD, Wanda Michej, MD, Maria Dębiec-Rychter, MD, PhD, Agnieszka Woźniak, PhD, Janusz Limon, PhD, Janusz Siedlecki, PhD, Urszula Grzesiakowska, MD, PhD, Michał Kąkol, MD, Czesław Osuch, MD, PhD, Marcin Polkowski, MD, PhD, Stanisław Głuszek, MD, PhD, Zbigniew Żurawski, MD, Włodzimierz Ruka, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2007

Abstract

Background

The introduction of adjuvant imatinib in gastrointestinal stromal tumors (GISTs) raised debate over the accuracy of National Institutes of Health risk criteria and the significance of other prognostic factors in GIST.

Methods

Tumor aggressiveness and other clinicopathological factors influencing disease-free survival (DFS) were assessed in 335 patients with primary resectable CD117-immunopositive GISTs (median follow-up, 31 months after primary tumor resection) from a prospectively collected tumor registry.

Results

Overall median DFS was 37 months, and estimated 5-year DFS was 37.8 %. In univariate analysis, high or intermediate risk group (P < .000001), mitotic index >5/50 high-power field (P < .00001), primary tumor size >5 cm (P < .00001), nongastric primary location (P = .0001), male sex (P = .01), R1 resection/tumor rupture (P = .0003), and epithelioid cell or mixed cell pathological subtype (P = .05) negatively affected DFS. In multivariate analysis, statistically significant factors negatively influencing DFS for model 1 were mitotic index >5/50 high-power field (P = .004), primary tumor size >5 cm (P = .001), male sex (P = .003), R1 resection/tumor rupture (P = .04), and nongastric primary tumor location (P = .02), and for model 2 were high/intermediate risk primary tumor (P < .0001 and P = .008, respectively), male sex (P = .007), resection R1/tumor rupture (P = .01), and nongastric primary tumor location (P = .02). Five-year DFS for high, intermediate, and low/very low risk group was 20%, 54%, and 96%, respectively.

Conclusions

The risk criteria for assessing the natural course of primary GISTs were validated, but additional independent prognostic factors—primary tumor location and sex—were also identified.

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Title: Risk Criteria and Prognostic Factors for Predicting Recurrences After Resection of Primary Gastrointestinal Stromal Tumor
Authors: Piotr Rutkowski, MD, PhD
Zbigniew I. Nowecki, MD, PhD
Wanda Michej, MD
Maria Dębiec-Rychter, MD, PhD
Agnieszka Woźniak, PhD
Janusz Limon, PhD
Janusz Siedlecki, PhD
Urszula Grzesiakowska, MD, PhD
Michał Kąkol, MD
Czesław Osuch, MD, PhD
Marcin Polkowski, MD, PhD
Stanisław Głuszek, MD, PhD
Zbigniew Żurawski, MD
Włodzimierz Ruka, MD, PhD
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9377-9

At a glance: The STEP trials

Springer Medicine

Risk Criteria and Prognostic Factors for Predicting Recurrences After Resection of Primary Gastrointestinal Stromal Tumor

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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