Clinical Research Papers:
Prognostic role of the primary tumour site in patients with operable small intestine and gastrointestinal stromal tumours: a large population-based analysis
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Hua Ye1, Hua Xin2, Qi Zheng1, Qijun Shen3, Wenyu Dai1, Feng Wu1, Cheng Zheng1 and Ping Chen1
1Department of Gastrointestinal and Hernia Ward, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China
2Clinical Laboratory, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China
3Department of Health Statistics, Medical School of Ningbo University, Ningbo, Zhejiang, China
Ping Chen, email: firstname.lastname@example.org
Keywords: gastrointestinal stromal tumour; GIST; anatomic site; survival; SEER database
Received: July 06, 2017 Accepted: November 23, 2017 Published: December 22, 2017
The postoperative recurrence risk of gastrointestinal stromal tumour (GIST) should be estimated when considering adjuvant systemic therapy. Previous studies in the literature have suggested that small intestinal GISTs are more aggressive than gastric GISTs. We assessed the prognostic role of the primary tumour site in patients with operable GIST to compare the outcomes of gastric and small intestinal GISTs over a decade of treatment. The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of gastric and small intestinal GISTs between 2004 and 2014 using the GIST-specific histology code (ICD-O-3 code 8936), and only patients with tissues sampled by surgical resection were selected for this study. Cancer-specific survival (CSS) and overall survival (OS) were compared between small intestinal and gastric GISTs using Cox regression analyses. GISTs were located in the stomach (n = 2594, 65%), duodenum (n = 228, 6%), and jejunum/ileum (n = 1176, 29%). The OS and CSS of patients with GISTs in the duodenum and jejunum/ileum were similar to those of patients with gastric GISTs in Cox regression analyses, except for the CSS of patients with tumour sizes 2.1-5 cm in diameter and ≤ 5 mitoses per 50 HPFs (HR 1.657; 95% CI 1.062-2.587, p = 0.026). Tumours sizes 2.1–5 cm in diameter and > 5 mitoses per 50 HPFs (HR 4.627; 95% CI 1.035-20.67, p = 0.045) in jejunal/ileal GIST locations had significantly worse CSS than did those in gastric GIST locations. In this large nationwide study, the primary tumour site was not an independent prognostic factor in patients with operable small intestinal and gastric GISTs.
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