title: Prediction of risk of malignancy of gastrointestinal stromal tumors by endoscopic ultrasonography.
abstract: OBJECTIVE
  The accurate preoperative prediction of the risk of malignancy of gastrointestinal stromal tumors (GISTs) is difficult. The aim of this study was to determine whether tumor size and endoscopic ultrasonography (EUS) features can preoperatively predict the risk of malignancy of medium-sized gastric GISTs.
  
  
  METHODS
  Surgically resected, 2 to 5 cm gastric GIST patients were enrolled and retrospectively reviewed. EUS features, such as heterogeneity, hyperechoic foci, calcification, cystic change, hypoechoic foci, lobulation, and ulceration, were evaluated. Tumors were grouped in 1 cm intervals. The correlations of tumor size or EUS features with the risk of malignancy were evaluated.
  
  
  RESULTS
  A total of 75 patients were enrolled. The mean tumor size was 3.43±0.92 cm. Regarding the risk of malignancy, 51 tumors (68%) had a very low risk, and 24 tumors (32%) had a moderate risk. When the tumors were divided into three groups in 1 cm intervals, the proportions of tumors with a moderate risk were not different between the groups. The preoperative EUS features also did not differ between the very low risk and the moderate risk groups.
  
  
  CONCLUSIONS
  Tumor size and EUS features cannot be used to preoperatively predict the risk of malignancy of medium-sized gastric GISTs. A preoperative diagnostic modality for predicting risk of malignancy is necessary to prevent the overtreatment of GISTs with a low risk of malignancy.
authors: Seoul National University Hospital Healthcare System, Seoul National University College of Medicine, Seoul, Korea.
authors: Mi Na
authors: MN
authors: Kim
authors: Seung Joo
authors: SJ
authors: Kang
authors: Sang Gyun
authors: SG
authors: Kim
authors: Jong Pil
authors: JP
authors: Im
authors: Joo Sung
authors: JS
authors: Kim
authors: Hyun Chae
authors: HC
authors: Jung
authors: In Sung
authors: IS
authors: Song
mesh_terms: D000368:Aged; D019160:Endosonography; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D047368:Tumor Burden
keywords: Endosonography; Gastrointestinal stromal tumors; Malignant risk; Tumor size