[Diagnosis and treatment of gastrointestinal stromal tumors: report of 135 cases].
OBJECTIVE
To analyze the relationships between smooth-muscle tumors of gastrointestinal (GI) tract and gastrointestinal stromal tumors (GISTs), and the efficacy of surgical management.


METHODS
The clinical and pathological data of 135 cases of GISTs were collected, including cases of leiomyomas/leiomyosarcoma between 1993 and 2003 and GIST between Jan. 2000 and Jul. 2005. The surgical outcomes were analyzed retrospectively.


RESULTS
82.1% of former leiomyomas/leiomyosarcomas was corrected to GISTs. Overall 5-year survival rate was 79.7%. Univariate analysis revealed preoperative metastasis, tumor size, mitotic index, and postoperative metastasis or recurrence were correlated with overall survival in patients with completed resection. Multivariate analysis showed that only postoperative metastasis or recurrence were the indicators of poor prognosis, but without statistical significance (P=0.064). However, multivariate analysis for disease-free survival showed that preoperative metastasis and mitotic index were two independent predictors of poor prognosis (P=0.001 and P<0.001).


CONCLUSIONS
Most former leiomyomas/leiomyosarcomas of GI tract should be corrected to the diagnosis of GISTs. Complete surgical resection is the choice of treatment for GISTs. Preoperative metastasis and mitotic index are two independent predictors of poor prognosis.
Zhang
Xin-Hua
XH
Department of Gastrointestinopancreatic Surgery, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou 510080, China.
He
Yu-Long
YL
Zhan
Wen-Hua
WH
Cai
Shi-Rong
SR
Zhang
Chang-Hua
CH
D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D015996:Survival Rate