The outcome of gastrointestinal stromal tumors (GISTs) after a surgical resection in our institute.
OBJECTIVE
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract arising from Cajal's cells and expressing c-kit. In a consensus report, the clinical behavior of GISTs was categorized into risk classes according to the tumor size and mitotic count. We analyzed the risk categories based on GIST patients who underwent a surgical resection at our institute during a period of 15 years.


METHODS
We evaluated the risk categories of GISTs and analyzed the outcome and risk categories retrospectively. We presented the MIB-1 score of the tumor instead of mitotic counts for the evaluation of cellular growth because of inaccuracies regarding the mitotic counts.


RESULTS
Patients were classified into 4 cases of very low risk, 11 of low risk, 8 of intermediate risk, and 5 of high risk. Four high-risk patients showed recurrence as either liver metastasis or peritoneal dissemination. In addition, local recurrence occurred in one low-risk and one intermediate-risk patient each.


CONCLUSIONS
Our cases confirmed the correlation between the risk categories and the prognosis. A complete resection with sufficient margin must be confirmed even in low-risk cases to prevent local recurrence. Since high-risk patients showed poor prognosis, the adjuvant treatment with chemotherapeutic regimens must therefore be further studied for high-risk patients.
Tsukuda
Kazunori
K
Department of Surgery, Okayama Red Cross General Hospital, 2-1-1 Aoe, Okayama 700-8607, Japan.
Hirai
Ryuji
R
Miyake
Takayoshi
T
Takagi
Shoji
S
Ikeda
Eiji
E
Kunitomo
Tadayoshi
T
Tsuji
Hisashi
H
D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D009418:S100 Proteins / Q000378:metabolism; D015996:Survival Rate; D016896:Treatment Outcome
D000199:Actins; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009418:S100 Proteins; C110294:S100A1 protein