Surgery of upper GI gastrointestinal stromal tumors: our experience, prognostic analysis

Hepatogastroenterology. 2015 Jan-Feb;62(137):87-92.

Abstract

Background/aims: To review our treatment experience of gastrointestinal stromal tumors (GISTs) of the upper gastrointestinal tract and identify the prognostic factors that influence tumor recurrence.

Methodology: Data of 46 consecutive patients with upper GI GISTs who underwent surgery from 1988 to 2011 were reviewed. The overall and disease-free survival rates and influence of clinicopathologic variables on disease-free survival rate were evaluated.

Results: The median age was 64 years (range, 20-86 years). R0 resections were performed in 43 (93.5%) patients. With a median follow-up time of 33 months (1-275 months), there were 5 (10.9%) recurrences and 2 mortalities in the high-risk group. The overall survival and recurrence-free survival rates at 5 years were 92.1% and 84.6%, respectively. Male gender, tumor size of >10 cm, high numbers of mitotic figures, R1 resection, high risk according to the Joensuu criteria, and a Ki-67 index of >10% were associated with a poor prognosis.

Conclusions: Surgical resection of low- and intermediate-risk GISTs has excellent results. High counts of mitotic figures, male gender, incomplete resection, large tumor size, and a high Ki-67 index are associated with a poor prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Proliferation
  • Disease-Free Survival
  • Female
  • Gastrointestinal Stromal Tumors / chemistry
  • Gastrointestinal Stromal Tumors / mortality
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery*
  • Humans
  • Intestinal Neoplasms / chemistry
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology
  • Intestinal Neoplasms / surgery*
  • Intestine, Small / chemistry
  • Intestine, Small / pathology
  • Intestine, Small / surgery*
  • Kaplan-Meier Estimate
  • Ki-67 Antigen / analysis
  • Male
  • Middle Aged
  • Mitotic Index
  • Neoplasm Recurrence, Local
  • Neoplasm, Residual
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Stomach Neoplasms / chemistry
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome
  • Tumor Burden
  • Young Adult

Substances

  • Ki-67 Antigen