title: Clinicopathologic factors predicting outcomes in patients with gastrointestinal stromal tumors of the rectum and colon.
abstract: Limited information is available concerning the clinicopathologic profile of colorectal gastrointestinal stromal tumors (GISTs), which are relatively rare, as well as survival rates following surgical resection. The present study was designed to describe the clinicopathologic characteristics of patients with colorectal GISTs and identify potential factors that may predict postoperative survival outcomes. We reviewed the medical records of 67 patients with colorectal GISTs who underwent surgical resection between January 2000 and December 2012. Clinicopathologic factors affecting overall survival were assessed using the Kaplan-Meier method and multivariate Cox proportional hazards models. The median age at diagnosis was 57 years (range, 32-79 years), with a male-to-female ratio of 1.68. Tumor size varied from 0.2 to 11 cm, with a median size of 5.7 cm. Sixty-two tumors (93%) were positive for CD117, 53 (79%) for CD34, 6 (9%) for PDGFRA, 15 (22%) for SMA, 5 (8%) for S100, and 39 (58%) for vimentin. The overall median survival time was 54 months (95% confidence interval, 32-59 months), and the 1-, 3-, and 5-year overall survival rates were 89.6, 63.9, and 34.4%, respectively. High-risk tumors (determined by histologic grade, size, and other histologic variables) were associated with poor prognosis (hazard ratio, 1.83; 95% confidence interval, 1.21-2.78), and patients who received adjuvant treatment with imatinib had significantly longer median overall survival times than patients who did not (hazard ratio, 0.43; 95% confidence interval, 0.24-0.80). In patients with colorectal GISTs, high-risk tumor histologic grade can predict poor prognosis, and patients may benefit from adjuvant treatment with imatinib. Findings from the present study may provide information to establish evidence-based management strategies for colorectal GISTs.
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651# DongFeng East Road, GuangZhou, 510060, People's Republic of China.
authors.forename: Zhongguo
authors.initials: Z
authors.lastname: Zhou
authors.forename: Zhanpeng
authors.initials: Z
authors.lastname: Chen
authors.forename: Minshan
authors.initials: M
authors.lastname: Chen
authors.forename: Ruojing
authors.initials: R
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Yin
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate