title: Gastrointestinal stromal tumors: prognostic factors and therapeutic implications.
abstract: BACKGROUND
  Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal tumors of the digestive tract. They have recently been recognized as a separate nosological entity and the literature on these stromal tumors has rapidly expanded.
  
  
  METHODS
  The surgical records of 50 patients with primary GISTs treated at the Digestive Surgery Department of the Catholic University of Rome from January 1993 to December 2010 were reviewed and the prognostic factors were analyzed.
  
  
  RESULTS
  Surgery was performed in all patients with curative intent. The median age at presentation was 66.5 years (range, 28-81). Adjuvant therapy was administered in 26 (52%) cases. Median follow-up was 71 months (range, 5-208). There was an 8% recurrence rate. The actuarial 5-year overall and disease-free survival rates were 66.3% and 57.2%, respectively. High mitotic rate (P <0.001), tumor size greater than 10 cm (P = 0.007) and tumor rupture (P = 0.05) were the only prognostically significant negative factors for overall survival in multivariate analysis.
  
  
  CONCLUSIONS
  The present study confirmed the important role of aggressive surgical management of GISTs to offer these patients the most appropriate treatment for long-term survival.
authors: Department of Digestive Surgery, Agostino Gemelli Hospital, Catholic University of Rome, Rome, Italy. faust.rosa@tiscali.it
authors: Fausto
authors: F
authors: Rosa
authors: Sergio
authors: S
authors: Alfieri
authors: Antonio Pio
authors: AP
authors: Tortorelli
authors: Dario
authors: D
authors: Di Miceli
authors: Valerio
authors: V
authors: Papa
authors: Riccardo
authors: R
authors: Ricci
authors: Giovanni Battista
authors: GB
authors: Doglietto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents