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Observational Study
. 2017 Dec 6;17(1):141.
doi: 10.1186/s12876-017-0705-7.

Two staging systems for gastrointestinal stromal tumors in the stomach: which is better?

Chul Hong Park  1 , Gwang Ha Kim  2 , Bong Eun Lee  1 , Geun Am Song  1 , Do Youn Park  3 , Kyung Un Choi  3 , Dae Hwan Kim  4 , Tae Yong Jeon  4
Affiliations
Observational Study

Two staging systems for gastrointestinal stromal tumors in the stomach: which is better?

Chul Hong Park et al. BMC Gastroenterol. .

Abstract

Background: The prognosis of a gastrointestinal stromal tumor (GIST) is influenced by its anatomic site; however, few studies on the prognosis of gastric GISTs have been reported. The aims of this study were to evaluate long-term prognoses of patients who underwent surgical resection for gastric GISTs and to compare the clinical efficacy of two staging systems: the National Institutes of Health (NIH) consensus criteria and the 7th Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) tumor-node-metastasis (TNM) staging system.

Methods: We conducted a retrospective observational study of 145 patients who underwent surgical resection for gastric GISTs between February 2001 and June 2012 at Pusan National University Hospital (Busan, Korea). Recurrence and 5-year recurrence-free survival (RFS) rates were analyzed.

Results: During a median follow-up period of 44 months (range, 6-144 months), 11 recurrent lesions were detected in 9 patients (6.4%). On multivariate analysis, tumor size (>5 cm), mitotic count (>5/50 high-power fields), and epithelioid and mixed pathological type were significantly associated with recurrence. The overall 5-year RFS rate was 93.4%. Although no statistically significant differences were detected (C-statistic difference P = 0.886), all metrics showed lower values for the UICC/AJCC TNM staging system than for the NIH consensus criteria, suggesting that the UICC/AJCC TNM staging system may be a better model.

Conclusions: The 5-year RFS rate in patients who underwent curative resection for gastric GISTs was excellent. The UICC/AJCC TNM staging system may be more useful than the NIH consensus criteria for risk categorization of patients with gastric GISTs.

Keywords: Gastrointestinal stromal tumors; Prognosis; Recurrence; Staging; Stomach.

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Conflict of interest statement

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of Pusan National University Hospital (E-2015216).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Histologic subtypes of GISTs. a Spindle cell type. The tumor is composed of fusiform spindle cells with a fascicular growth pattern. b Epithelioid type. The tumor is composed of large round or polygonal cells with abundant, often eosinophilic or clear cytoplasm. c Mixed type. The tumor is composed of mixture of both types (hematoxylin and eosin staining, original magnification x400).
Fig. 2
Fig. 2
Recurrence-free survival rate of patients undergoing surgical resection for gastric GISTs according to the NIH consensus criteria
Fig. 3
Fig. 3
Recurrence-free survival rate of patients undergoing surgical resection for gastric GISTs according to the 7th UICC/AJCC TNM staging system
See this image and copyright information in PMC

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