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Long-Term Surgical Outcome of 1057 Gastric GISTs According to 7th UICC/AJCC TNM
System: Multicenter Observational Study From Korea and Japan
#MMPMID26469894
Kim MC
; Yook JH
; Yang HK
; Lee HJ
; Sohn TS
; Hyung WJ
; Ryu SW
; Kurokawa Y
; Kim YW
; Han SU
; Kim HH
; Park DJ
; Kim W
; Lee SI
; Cho H
; Cho GS
; Kim JJ
; Kim KH
; Yoo MW
Medicine (Baltimore)
2015[Oct]; 94
(41
): e1526
PMID26469894
show ga
The aim of this study was to evaluate the treatment and prognosis of gastric
gastrointestinal stromal tumors (GISTs) according to the 7th UICC/AJCC
tumor-node-metastasis (TNM) system and the modified National Institutes of Health
(NIH) risk classification. The study cohort consisted of 1057 patients with
gastric GIST who underwent surgery between January 2000 and December 2007 from 13
institutions in Korea and 2 in Japan. Clinicopathologic characteristics, surgical
outcomes, recurrence, and 5-year recurrence-free survival were evaluated.The mean
age of the patients was 58.6 years. Thirty patients (2.8%) had distant metastasis
preoperatively. Median tumor size was 4.0?cm. Complete resection (R0 resection)
was achieved in 1018 patients (96.3%). Eighty-six patients (8.1%) had
postoperative complications, and 2 patients (0.2%) died within 30 days after
surgery. According to the 7th UICC/AJCC TNM system, 5-year recurrence-free
survival rates were 95% to 99% in stage I, 94.1% in stage II, 74.1% in stage
IIIA, 48.6% in stage IIIB, and 50.0% in stage IV patients. On survival analysis
of high-risk patients according to the TNM system, the 5-year recurrence-free
survival rates were 91.6% in stage II, 74.1% in stage IIIA, and 48.6% in stage
IIIB patients. Independent factors of recurrence following surgery for gastric
GIST were gender, tumor size, mitotic count, and radicality on multivariate
analysis.The treatment outcome and prognosis of gastric GIST in Korea and Japan
seem more favorable compared to those in Western countries. Compared to the
modified NIH risk classification, the 7th UICC/AJCC TNM system is more reflective
of the 5-year recurrence-free survival of patients with gastric GIST.
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