Clinical analysis of 217 patients with gastrointestinal stromal tumor / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical characteristics, diagnosis, treatment and prognostic factors of gastrointestinal stromal tumor(GIST).</p><p><b>METHODS</b>Clinicopathological data of 217 GIST patients from January 2005 to September 2010 in Wuhan Union Hospital were analyzed retrospectively and the prognostic factors were evaluated.</p><p><b>RESULTS</b>There were 103 males and 114 females with a median age of 55 years old. Two hundred and thirteen patients underwent R0 resection and 4 R1 resection due to extensive invasion. Thirty-five patients underwent laparoscopic resection. Forty-eight patients received imatinib mesylate therapy after surgery. A total of 178 patients(82.0%) were followed up for 3 to 74 months. Sixteen patients(9.0%) developed recurrence or metastasis. Logistic regression analysis showed that tumor location (OR=2.547, 95% CI1.466-4.424) and mitotic count(OR=6.556, 95% CI2.974-14.449) were independent factors for post-operative recurrence or metastasis. Five patients survived with tumor, and 11 patients(6.2%) died of GIST including intestinal GIST(n=7) and extraintestinal GIST(n=4). Cox regression analysis showed that the mitotic count (RR=2.654, 95% CI1.094-6.438) and post-operative recurrence or metastasis (RR=32.988, 95% CI3.879-280.529) were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Tumor location and mitotic count are independent risk factors for post-operative recurrence or metastasis in GIST. Mitotic count and post-operative recurrence or metastasis are independent indicators of poor prognosis. Surgical radical resection combined with targeted therapy can achieve satisfactory outcomes in patients with GIST.</p>