title: Outcomes and prognostic factors of primary gastric GIST following complete surgical resection: a single surgeon experience.
abstract: OBJECTIVE
  To examine the surgical outcomes and to identify prognostic factors influencing tumor recurrence and survival after curative resection of primary gastric GIST as performed by one surgeon.
  
  
  METHODS
  The medical records of patients with primary gastric GIST (c-kit or CD117-positive) who underwent curative resection by one surgeon between January 2001 and March 2009. The clinicopathological features, tumor recurrence, and recurrence-free survival were assessed.
  
  
  RESULTS
  Twenty-two patients (10 males and 12females) with a median age of 66 years (range, 39-98 yrs) were reviewed. According to the NIH risk criteria, high-risk, intermediate-risk and low-risk GISTs were found in 12 (54.5%), one (4.5%), and nine (41%) patients, respectively. After a median follow-up of 42 months (range, 19-96 months), three patients (13.6%) developed tumor recurrence, all of whom had high-risk GIST. No patient died during this follow-up period The recurrence-free probability at 5 years was 88% (95% CI; 59%-97%). Univariable analysis showed that high mitotic count (> 5/50 HPF) was a significant predictor of tumor recurrence.
  
  
  CONCLUSIONS
  Low and intermediate-risk gastric GIST have an excellent prognosis after complete surgical resection alone, while high-risk group are associated with increased disease recurrence despite complete surgical resection. Adjuvant therapy should be advocated for patients with high-risk gastric GISTs. High mitotic count is an important prognostic factor for recurrence after surgery.
authors.affiliation: Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. racen@mahidol.ac.th
authors.forename: Chakrapan
authors.initials: C
authors.lastname: Euanorasetr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000145:classification / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D016130:Immunophenotyping; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D019009:Proto-Oncogene Proteins c-kit