title: Primary gastrointestinal sarcomas: analysis of prognostic factors and results of surgical management.
abstract: BACKGROUND
  This study was done to review the clinical presentation, surgical management, and prognostic factors for primary gastrointestinal sarcomas.
  
  
  METHODS
  We reviewed medical records of 55 patients who were treated for primary gastrointestinal sarcomas from 1981 through 1996. Mean follow-up time was 32 months.
  
  
  RESULTS
  Clinical findings included gastrointestinal bleeding (51%), palpable mass (36%), and abdominal pain (33%). The stomach was the most common site of disease (53%), followed by the small intestine (33%). Tumors were high grade in 76% of patients and low-grade in 24% of patients. Complete resection of all gross disease was accomplished in 35 patients (64%), incomplete resection in 17 patients (31%), and biopsy only in 3 patients (5%). Adjacent organ resection was required in 19 patients (35%). Overall actuarial survival was 22% (median survival, 32 months). Unfavorable prognostic factors were incomplete resection, high-grade histologic features, and tumor size of 5 cm or more (P<.05). En bloc resection of contiguous organs did not adversely effect survival. In patients with complete resections, tumor grade was the most important prognostic factor (median survival, 55 months vs 19 months for low-grade vs high-grade tumors; P<.05).
  
  
  CONCLUSIONS
  Aggressive surgical resection, including en bloc resection of locally advanced tumors, appears warranted. Despite complete resections, patients with high-grade tumors remain at risk for recurrence.
authors.affiliation: Department of Surgery, Northwestern University Medical School, Chicago, Ill. 60611, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Yao
authors.forename: M S
authors.initials: MS
authors.lastname: Talamonti
authors.forename: R L
authors.initials: RL
authors.lastname: Langella
authors.forename: N M
authors.initials: NM
authors.lastname: Schindler
authors.forename: S
authors.initials: S
authors.lastname: Rao
authors.forename: W
authors.initials: W
authors.lastname: Small
authors.forename: R J
authors.initials: RJ
authors.lastname: Joehl
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome