title: Clinicopathologic analysis of gastrointestinal stromal tumors in duodenum and small intestine.
abstract: BACKGROUND
  The prognosis about duodenal GISTs is debatable. The purpose of this study is to compare the characteristics and the prognostic factors in patients with gastrointestinal stromal tumor (GIST) located in the duodenum with those located in the small intestine.
  
  
  METHODS
  One hundred-one patients with GIST located in the duodenum (n = 40), or small intestine (n = 61) underwent resection between 1996 and 2010. We analyzed clinicopathologic features, surgical outcomes, and prognostic factors.
  
  
  RESULTS
  Five-year survival rate in patients with GIST located in the duodenum and small intestine were 66.6 and 80.8%, respectively (p = 0.018). After survival analysis, high mitotic count and tumor rupture were identified as independent adverse prognostic factors. Advanced T stage and absence of adjuvant imatinib treatment were adverse prognostic factors with marginal statistical significance. The rate of progressive disease was significantly higher in patients with duodenal GISTs (36.8%) than in those with small intestinal GIST (29.6%) (p = 0.024).
  
  
  CONCLUSIONS
  The clinicopathologic findings of duodenal GIST differ from those of small intestinal GIST. Patients with duodenal GIST have a worse prognosis than those with small intestinal GIST. Aggressive treatment including surgical resection should be considered for duodenal GIST, even if the risk is relatively low.
authors.affiliation: Department of Surgery, Dongguk University College of Medicine, Goyang, South Korea, cardioman76@gmail.com.
authors.forename: In Woong
authors.initials: IW
authors.lastname: Han
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Kyoung Bun
authors.initials: KB
authors.lastname: Lee
authors.forename: Mee Joo
authors.initials: MJ
authors.lastname: Kang
authors.forename: Wooil
authors.initials: W
authors.lastname: Kwon
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Ye Rim
authors.initials: YR
authors.lastname: Chang
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007078:Ileal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000068877:Imatinib Mesylate; D007580:Jejunal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000473:pathology; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate