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Frontiers of Medicine

Front Med    2012, Vol. 6 Issue (3) : 317-321     DOI: 10.1007/s11684-012-0203-9
Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors
Qinggang Hu, Shanglong Liu, Jianwei Jiang, Chen Zhang, Xiaowei Liu, Qichang Zheng()
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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In order to find out the potential indicators predicting prognosis of malignant gastrointestinal stromal tumors (GISTs) after surgical resection, we collected clinical records of 80 patients with malignant GISTs. Tumor location, size, mitotic index, necrosis were compared with the prognosis of malignant GISTs by Kaplan-Meier method and log-rank test. After a median follow-up of 844 days (52–2 145), we found that as National Institutes of Health suggested, tumors with intermediate risk had more favorable prognosis than that with high risk. Their 3-year survival rate were 65.3% and 41.3%, respectively (P<0.001). Moreover, tumor size and mitotic index were associated with free survival. The 3-year survival rate for patients with tumor size≤10 cm and>10 cm were 62.3% and 41.8%, respectively (P = 0.002), Tumors with mitotic index≤5/50 HPF had a higher 3-year survival rate than tumors with mitotic index>5/50 HPF (67.1% versus 40.7%, P = 0.005). The presence of necrosis was directly related to the malignant behavior. The 3-year survival rate for presence and absence necrosis were 50.8% and 64.8% (P = 0.008). From the present study, we can conclude that besides tumors size and mitotic index, tumor location and necrosis also influence on the long-term survival of patient with malignant GISTs after surgical resection.

Keywords gastrointestinal stromal tumors      surgery      survival     
Corresponding Authors: Zheng Qichang,   
Issue Date: 05 September 2012
 Cite this article:   
Jianwei Jiang,Chen Zhang,Xiaowei Liu, et al. Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors[J]. Front Med, 2012, 6(3): 317-321.
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Jianwei Jiang
Chen Zhang
Xiaowei Liu
Qichang Zheng
Qinggang Hu
Shanglong Liu
Fig.1  Age and gender distributions of patients with malignant GISTs.
FactorsNumber of cases
Female42 (52.5%)
Male38 (47.5%)
≤60 years56 (70%)
&gt;60 years24 (30%)
Present65 (81.3%)
Absent15 (18.7%)
Site of origin
Stomach26 (32.5%)
Small intestine31 (38.7%)
Rectum10 (12.5%)
Others13 (16.3%)
Mitotic index
≤5/50 HPF55 (68.7%)
&gt;5/50 HPF25 (31.3%)
Tumor size
≤5 cm7 (8.8%)
&gt;5 cm and≤10 cm45 (56.2%)
&gt;10 cm28 (35.0%)
Present45 (56.7%)
Absent35 (43.7%)
Present23 (28.7%)
Absent57 (71.3%)
Recurrence after surgery
Yes18 (22.5%)
No62 (77.5%)
Tab.1  Clinical data of patients with malignant GISTs
Fig.2  Survival of patients with intermediate risk versus patients with high risk GISTs.
Fig.3  Survival of malignant GISTs in different locations (stomach versus small intestine).
Fig.4  Survival of patients with malignant GISTs based on tumor size (size≤10 cm versus size>10 cm).
Fig.5  Survival of patients with malignant GISTs based on mitotic index.
Fig.6  Survival of patients with malignant GISTs based on necrosis (absence of necrosis versus presence of necrosis).
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