title: Treatment and risk factors for recurrence after curative resection of gastrointestinal stromal tumors of the stomach.
abstract: The current definitive treatment for gastrointestinal stromal tumor (GIST) of the stomach is complete resection. GIST has a highly variable clinical course, and recurrent disease sometimes develops despite curative treatment. Although several known risk factors for recurrence exist, adequate treatment strategies are lacking. This study evaluated factors associated with relapse after curative treatment. Sixty patients with gastric GIST were identified from a hospital disease registry database. Clinicopathologic characteristics of these patients were reviewed and the Cox proportional hazards regression analysis was used to identify recurrent risk factors. With a median follow-up of 60 months (range 5-286 months), recurrence occurred in eight (13%) patients, three of whom underwent resection of the recurrent disease and are alive to date. Univariate analysis demonstrated that invasion of the adjacent organs (p = 0.0005), tumor size (p = 0.0046), and expression of proliferative markers [MIB-1 proliferative index (PI) > or = 10%] (p = 0.0001) were significant risk factors for recurrence. Multivariate analysis with these three factors as variables revealed that only MIB-1 PI was a significant independent risk factor for recurrence (p = 0.0051). In conclusion, surgical resection may be indicated whenever a recurrent GIST is considered resectable. A high MIB-1 PI was identified as an independent indicator of risk for recurrent disease following curative surgery.
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, 464-8681 Nagoya, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirai
authors.forename: Kenzo
authors.initials: K
authors.lastname: Yasui
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Inada
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*