Gastrointestinal Stromal Tumor (GIST) of the Stomach: Clinicopathologic Analysis and Outcome.
10.5230/jkgca.2005.5.1.40
- Author:
Je Seock RYU
1
;
Sung Ryul LEE
;
Sae Byeol CHOI
;
Sung Soo PARK
;
Ju Han LEE
;
Seung Joo KIM
;
Chong Suk KIM
;
Yang Seok CHAE
;
Young Jae MOK
Author Information
1. Department of Surgery, Korea University College of Medicine, Seoul, Korea. yjmok@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Stomach;
Gastrointestinal stromal tumor;
GIST
- MeSH:
Diagnosis;
Disease Progression;
Disease-Free Survival;
Follow-Up Studies;
Gastrointestinal Stromal Tumors*;
Gastrointestinal Tract;
Humans;
Immunohistochemistry;
Korea;
Mesylates;
Multivariate Analysis;
Necrosis;
Neoplasm Metastasis;
Prognosis;
Proto-Oncogene Proteins c-kit;
Recurrence;
Retrospective Studies;
Stomach*;
Ulcer;
Ultrasonography;
Imatinib Mesylate
- From:Journal of the Korean Gastric Cancer Association
2005;5(1):40-46
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. MATERIALS AND METHODS: 40 patients who underwent a complete resection of a GIST during the period 1996~2003 at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. RESULTS: The mean age of the 40 patients was 61.3+/-11.1 years, and the male-to-female ratio was 1:1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, Gleevec(R)). The treated patients have survived until now; however, two of non-treated patients died from disease progression. CONCLUSION: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.
