What is the prognostic significance of metastatic lymph nodes in GIST?
OBJECTIVE
So many variables have been identified as prognostic factors influencing survival after curative resection in gastrointestinal stromal tumors (GIST), but the role of lymph node metastasis remains uncertain.


METHODS
Twenty-nine patients with c-Kit positive gastric GIST who underwent surgical resection at the Brazilian National Cancer Institute between 1983 and 2004 were reviewed retrospectively. The prognostic significance of lymph node metastasis was investigated. The endpoints were overall survival and disease free survival.


RESULTS
The median follow-up was 35 months. The 5-years estimate survival rate was 53%. Three patients presented lymph node metastasis and developed recurrence disease. Univariate analysis for overall survival identified the size >13.5cm (p = 0.01) and recurrence (p = 0.03) as prognostic factors. Size > 13.5cm and recurrence were independent factors (p = 0.01 and p = 0.03, respectively) in the multivariate analysis. Univariate analysis for disease free survival identified the size > 13.5cm (p = 0.04) and the grade (p = 0.04) as prognostic factors but, only the size > 13.5cm was an independent factor in the multivariate analysis. Lymph node metastasis had no prognostic significance for overall and disease free survival (p = 0.65 and p = 0.57, respectively).


CONCLUSIONS
GIST lymph node metastasis was not related to poor survival in this study, but more studies are needed to identify the real incidence and the proper role of the GIST metastatic nodal disease.
Valadão
Marcus
M
Department of Surgical Oncology, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil. marcusvaladao@terra.com.br
de Mello
Eduardo Linhares Riello
EL
Lourenço
Laercio
L
Vilhena
Bruno
B
Romano
Sérgio
S
Castro
Leonaldson dos Santos
Ldos S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality* / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult