Re-appraisal of risk classifications for primary gastrointestinal stromal tumors (GISTs) after complete resection: indications for adjuvant therapy
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- 作者：Yoshitomo Yanagimoto ; Tsuyoshi Takahashi ; Kazuya Muguruma…
- 关键词：Gastrointestinal stromal tumor ; Risk stratification ; Adjuvant therapy ; Recurrence ; Prognosis
- 刊名：Gastric Cancer
- 出版年：2015
- 出版时间：April 2015
- 年：2015
- 卷：18
- 期：2
- 页码：426-433
- 全文大小：536 KB
- 参考文献：1. Joensuu, H (2008) Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 39: pp. 1411-1419 CrossRef
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14. Fletcher, CD, Berman, JJ, Corless, C, Gorstein, F, Lasota, J, Longley, BJ (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33: pp. 59-465
15. Edge, SB, Byrd, DR, Compton, CC, Fritz, AG, Greene, FL, Trotti, A (2010) AJCC staging manual. Springer, New York
16. Takahashi, T, Nakajima, K, Nishitani, A, Souma, Y, Hirota, S, Sawa, Y (2007) An enhanced risk-group stratification system for more practical prognostication of clinically malignant gastrointestinal stromal tumors. Int J Clin Oncol. 12: pp. 369-374 CrossRef
17. Rutkowski, P, Bylina, E, Wozniak, A, Nowecki, ZI, Osuch, C, Matlok, M (2011) Validation of the Joen - 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Oncology
Gastroenterology
Surgical Oncology
Pathology
Radiotherapy - 出版者：Springer Japan
- ISSN：1436-3305
文摘
Background A substantial number of localized gastrointestinal stromal tumor (GIST) patients have recurrences even after complete resection. The risk of recurrence after complete resection should be estimated when considering adjuvant therapy. In this study, we evaluated prognostic factors of GIST recurrence and compared several reported risk-stratification schemes for defining risk of recurrence to guide the use of adjuvant therapy using data from a large Japanese GIST population. Methods We analyzed clinicopathological data collected retrospectively and prospectively from 712 GISTs with complete resection from 1980-010. We evaluated possible prognostic factors and compared the National Institutes of Health consensus criteria, the Armed Forces Institute of Pathology criteria, Joensuu’s modified NIH classification (J-NIHC), the American Joint Committee on Cancer staging system (AJCCS), and the Japanese modified NIH criteria for prediction of tumor recurrence in adjuvant settings. Results Univariate analysis suggested that the following factors were prognostic: tumor size, mitotic count, site, clinically malignant features of rupture and/or invasion, and gender. In multivariate analysis, size?>5?cm, mitotic count?>5/50 HPF, non-gastric location, and the presence of rupture and/or macroscopic invasion were independent adverse prognostic factors. When adjuvant therapy is considered for patients with high-risk GIST, the J-NIHC was the most sensitive classification system, while the AJCCS appeared to be the most accurate for predicting recurrence. Conclusion Tumor size, mitotic count, tumor site, and clinical features of rupture and/or invasion were important prognostic factors for GIST recurrence. Joensuu’s classification appeared to best identify candidates for adjuvant therapy.