title: The outcome of gastrointestinal stromal tumors (GISTs) after a surgical resection in our institute.
abstract: 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.
authors.affiliation: Department of Surgery, Okayama Red Cross General Hospital, 2-1-1 Aoe, Okayama 700-8607, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tsukuda
authors.forename: Ryuji
authors.initials: R
authors.lastname: Hirai
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Miyake
authors.forename: Shoji
authors.initials: S
authors.lastname: Takagi
authors.forename: Eiji
authors.initials: E
authors.lastname: Ikeda
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Kunitomo
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsuji
mesh_terms: 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
chemical_list: D000199:Actins; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009418:S100 Proteins; C110294:S100A1 protein