title: Are there any prognostic factors for small intestinal stromal tumors?
abstract: BACKGROUND
  Stromal tumors of the digestive tract, or gastrointestinal stromal tumors (GIST), originate from an intestinal mesenchymal precursor cell. Criteria that predict the outcome of small intestinal stromal tumors (SIST) after surgical resection are not clearly established. The aim of the study was to define prognostic criteria for SIST.
  
  
  METHODS
  All c-kit positive SIST treated in our center over a 10-year period were reviewed.
  
  
  RESULTS
  Eighteen patients with SIST treated by surgical resection were included. Overall actuarial 5-year survival was 74% (median follow-up of 69 months). We developed a panel of five criteria (tumor size, mitotic rate, proliferation index, presence of necrosis, and invasion of mucosa or adjacent structures) that permitted distinction between low and high malignant potential SIST. Presence of any four of these five criteria defined a high malignant potential SIST, and was associated with disease recurrence and poor prognosis after surgical resection (P <0.01). Patients with low malignant potential SIST had a 5-year survival of 92%, compared with 0% for high malignant potential SIST (P <0.01).
  
  
  CONCLUSIONS
  This study demonstrates that a panel of morphologic factors can reliably distinguish between low and high malignant potential SIST. Although patients with low malignant potential SIST have an excellent prognosis after surgical resection, the role of adjuvant treatment for high malignant potential SIST remains to be defined.
authors.affiliation: Department of Surgery, University Hospital of Geneva, 24, Rue Micheli-du-Crest, 1211, Geneva 14, Switzerland. Pascal.Bucher@hcuge.ch
authors.forename: Pascal
authors.initials: P
authors.lastname: Bucher
authors.forename: Sophia
authors.initials: S
authors.lastname: Taylor
authors.forename: Peter
authors.initials: P
authors.lastname: Villiger
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Marie Anne
authors.initials: MA
authors.lastname: Brundler
mesh_terms: D000206:Actuarial Analysis; D018952:Antigens, CD34 / Q000032:analysis; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000401:mortality* / Q000601:surgery; D007580:Jejunal Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D017154:Stromal Cells; D013997:Time Factors
chemical_list: D018952:Antigens, CD34; D019009:Proto-Oncogene Proteins c-kit