title: Impact of age and gender on tumor related prognosis in gastrointestinal stromal tumors (GIST).
abstract: BACKGROUND
  Risk classification and prediction of prognosis in GIST is still a matter of debate. Data on the impact of age and gender as potential confounding factors are limited. Therefore we comprehensively investigated age and gender as independent risk factors for GIST.
  
  
  METHODS
  Two independent patient cohorts (cohort I, n = 87 [<50 years]; cohort II, n = 125 [≥50 years]) were extracted from the multicentre Ulmer GIST registry including a total of 659 GIST patients retrospectively collected in 18 collaborative German oncological centers. Based on demographic and clinicopathological parameters and a median follow-up time of 4.3 years (range 0.56; 21.33) disease-specific-survival (DSS), disease-free-survival (DFS) and overall survival (OS) were calculated.
  
  
  RESULTS
  GIST patients older than fifty years showed significantly worse DSS compared to younger patients (p = 0.021; HR = 0.307, 95% CI [0.113; 0.834]). DSS was significantly more favorable in younger female GIST patients compared with elderly females (p = 0.008). Female gender resulted again in better prognosis in younger patients (p = 0.033).
  
  
  CONCLUSIONS
  Patient age (<50 years) and female gender were significantly associated with a more favourable prognosis in GIST. Extended studies are warranted to confirm our clinical results and to elucidate underlying pathophysiological mechanisms.
authors.affiliation: Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. klaus.kramer@uniklinik-ulm.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kramer
authors.affiliation: Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. uwe.knippschild@uniklinik-ulm.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Knippschild
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, 89075, Germany. benjamin.mayer@uni-ulm.de.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Mayer
authors.affiliation: Department of Anesthesiology, Alb-Fils-Kliniken, Goeppingen, Goeppingen, 73035, Germany. k.boegelspacher@googlemail.com.
authors.forename: Kira
authors.initials: K
authors.lastname: Bögelspacher
authors.affiliation: Department of General and Visceral Surgery, Krankenhaus der Barmherzigen Brüder, Romanstraße 93, München, 80639, Germany. hannospatz@hotmail.com.
authors.forename: Hanno
authors.initials: H
authors.lastname: Spatz
authors.affiliation: Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. doris.henne-bruns@uniklinik-ulm.de.
authors.forename: Doris
authors.initials: D
authors.lastname: Henne-Bruns
authors.affiliation: Department of Clinical, Institute of Pathology, University of Erlangen, Erlangen, 91054, Germany. abbas.agaimy@uk-erlangen.de.
authors.forename: Abbas
authors.initials: A
authors.lastname: Agaimy
authors.affiliation: Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, 70376, Germany. matthias.schwab@ikp-stuttgart.de.|Department of Clinical Pharmacology, University Hospital, Tübingen, 72076, Germany. matthias.schwab@ikp-stuttgart.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwab
authors.affiliation: Department of Internal Medicine, Alb-Fils-Kliniken, Goeppingen, Goeppingen, 73035, Germany. GISTUlm@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Schmieder
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult