Surgery of upper GI gastrointestinal stromal tumors: our experience, prognostic analysis.
OBJECTIVE
To review our treatment experience of gastrointestinal stromal tumors (GISTs) of the upper gastrointestinal tract and identify the prognostic factors that influence tumor recurrence.


METHODS
Data of 46 consecutive patients with upper GI GISTs who underwent surgery from 1988 to 2011 were reviewed. The overall and disease-free survival rates and influence of clinicopathologic variables on disease-free survival rate were evaluated.


RESULTS
The median age was 64 years (range, 20-86 years). R0 resections were performed in 43 (93.5%) patients. With a median follow-up time of 33 months (1-275 months), there were 5 (10.9%) recurrences and 2 mortalities in the high-risk group. The overall survival and recurrence-free survival rates at 5 years were 92.1% and 84.6%, respectively. Male gender, tumor size of >10 cm, high numbers of mitotic figures, R1 resection, high risk according to the Joensuu criteria, and a Ki-67 index of >10% were associated with a poor prognosis.


CONCLUSIONS
Surgical resection of low- and intermediate-risk GISTs has excellent results. High counts of mitotic figures, male gender, incomplete resection, large tumor size, and a high Ki-67 index are associated with a poor prognosis.
Wisit
W
Kasetsermwiriya
Eishi
E
Nagai
Kohei
K
Nakata
Yosuke
Y
Nagayoshi
Shuji
S
Shimizu
Masao
M
Tanaka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049109:Cell Proliferation; D018572:Disease-Free Survival; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007414:Intestinal Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007421:Intestine, Small / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
D019394:Ki-67 Antigen