title: Preoperative predictors of malignant gastric submucosal tumor.
abstract: OBJECTIVE
  The preoperative prediction of malignant potential in patients with gastric submucosal tumors (SMTs) plays an important role in decisions regarding their surgical management.
  
  
  METHODS
  We evaluated the predictors of malignant gastric SMTs in 314 patients with gastric SMTs who underwent surgery in Chonnam National University Hospital.
  
  
  RESULTS
  The malignant SMTs were significantly associated with age (odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042 to 1.091; P < 0.0001), presence of central ulceration (OR, 2.690; 95% CI, 1.224 to 5.909; P = 0.014), and tumor size (OR, 1.791; 95% CI, 1.483 to 2.164; P < 0.0001). Receiver operating characteristic curve analysis showed that tumor size was a good predictor of malignant potential. The most relevant predictor of malignant gastric SMT was tumor size with cut-offs of 4.05 and 6.40 cm.
  
  
  CONCLUSIONS
  Our findings indicated that age, central ulceration, and tumor size were significant preoperative predictors of malignant SMTs. We suggest that 4 cm be selected as a threshold value for malignant gastric SMTs. In patients with a gastric SMT larger than 4 cm with ulceration, wide resection of the full thickness of the gastric wall or gastrectomy with adequate margins should be performed because of its malignant potential.
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Ho Goon
authors.initials: HG
authors.lastname: Kim
authors.forename: Seong Yeob
authors.initials: SY
authors.lastname: Ryu
authors.forename: Sang Kwon
authors.initials: SK
authors.lastname: Yun
authors.forename: Jae Kyoon
authors.initials: JK
authors.lastname: Joo
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Yi
authors.initials: DY
authors.lastname: Kim