title: Survival analysis of patients with duodenal gastrointestinal stromal tumors.
abstract: OBJECTIVE
  To evaluate the survival characteristics of patients with duodenal gastrointestinal stromal tumors (GISTs).
  
  
  BACKGROUND
  GISTs represent the most common mesenchymal neoplasms. However, duodenal GISTs are relatively rare, and few studies have been performed with a focus on duodenal GISTs.
  
  
  METHODS
  We collected the data of 41 GIST patients including 7 duodenal cases. Clinicopathologic findings and recurrence-free survival (RFS) of duodenal GIST patients were analyzed.
  
  
  RESULTS
  The proportion of having any symptoms was 86% in duodenum, 32% in stomach, and 56% in other GISTs (P=0.034), and the most common symptoms of duodenal GISTs were melena and anemia. The 2-year RFS rates were 51.4% in duodenal GISTs, 78.4% in stomach GISTs, and 100% in other GISTs, and duodenal GISTs showed poorer RFS than nonduodenal GISTs (hazard ratio, 5.1; log-rank P=0.019). Particularly, in low-risk and intermediate-risk group, the hazard ratio of recurrence was 12.3 (log-rank P=0.010). Multivariate Cox analysis showed symptom (P=0.007), mitotic index (P=0.011), and tumor location (P=0.043) were significant prognostic factors of recurrence.
  
  
  CONCLUSIONS
  RFS of duodenal GISTs was worse than nonduodenal GISTs.
authors.affiliation: Department of Surgery, Osaka National Hospital, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miki
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.forename: Yoko
authors.initials: Y
authors.lastname: Iwasa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Tsujinaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis