title: Population-based SEER trend analysis of overall and cancer-specific survival in 5138 patients with gastrointestinal stromal tumor.
abstract: BACKGROUND
  The objective of the present population-based analysis was to assess survival patterns in patients with resected and metastatic GIST.
  
  
  METHODS
  Patients with histologically proven GIST were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1998 through 2011. Survival was determined applying Kaplan-Meier-estimates and multivariable Cox-regression analyses. The impact of size and mitotic count on survival was assessed with a generalized receiver-operating characteristic-analysis.
  
  
  RESULTS
  Overall, 5138 patients were included. Median age was 62 years (range: 18-101 years), 47.3% were female, 68.8% Caucasians. GIST location was in the stomach in 58.7% and small bowel in 31.2%. Lymph node and distant metastases were found in 5.1 and 18.0%, respectively. For non-metastatic GIST, three-year overall survival increased from 68.5% (95 % CI: 58.8-79.8%) in 1998 to 88.6% (95 % CI: 85.3-92.0%) in 2008, cancer-specific survival from 75.3% (95 % CI: 66.1-85.9%) in 1998 to 92.2% (95 % CI: 89.4-95.1%) in 2008. For metastatic GIST, three-year overall survival increased from 15.0% (95 % CI: 5.3-42.6%) in 1998 to 54.7% (95 % CI: 44.4-67.3%) in 2008, cancer-specific survival from 15.0% (95 % CI: 5.3-42.6%) in 1998 to 61.9% (95 % CI: 51.4-74.5%) in 2008 (all PTrend < 0.05).
  
  
  CONCLUSIONS
  This is the first SEER trend analysis assessing outcomes in a large cohort of GIST patients over a 11-year time period. The analysis provides compelling evidence of a statistically significant and clinically relevant increase in overall and cancer-specific survival from 1998 to 2008, both for resected as well as metastatic GIST.
authors.affiliation: Division of Medical Oncology & Hematology, Kantonsspital St. Gallen, CH-9007, St. Gallen, Switzerland. Ulrich.Gueller@kssg.ch.|University Clinic for Visceral Surgery and Medicine, University Hospital Berne, 3010, Berne, Switzerland. Ulrich.Gueller@kssg.ch.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Güller
authors.affiliation: Department of General, Abdominal and Transplant Surgery, University of Heidelberg, 69120, Heidelberg, Germany. Ignazio.Tarantino@med.uni-heidelberg.de.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Tarantino
authors.affiliation: Division of Medical Oncology & Hematology, Kantonsspital St. Gallen, CH-9007, St. Gallen, Switzerland. Thomas.Cerny@kssg.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerny
authors.affiliation: Department of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland. Bruno.Schmied@kssg.ch.
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Schmied
authors.affiliation: Department of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland. Rene.Warschkow@kssg.ch.|Institute of Medical Biometry and Informatics, University of Heidelberg, 69120, Heidelberg, Germany. Rene.Warschkow@kssg.ch.
authors.forename: Rene
authors.initials: R
authors.lastname: Warschkow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018426:SEER Program; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult