title: Long-Term Surgical Outcome of 1057 Gastric GISTs According to 7th UICC/AJCC TNM System: Multicenter Observational Study From Korea and Japan.
abstract: The aim of this study was to evaluate the treatment and prognosis of gastric gastrointestinal stromal tumors (GISTs) according to the 7th UICC/AJCC tumor-node-metastasis (TNM) system and the modified National Institutes of Health (NIH) risk classification. The study cohort consisted of 1057 patients with gastric GIST who underwent surgery between January 2000 and December 2007 from 13 institutions in Korea and 2 in Japan. Clinicopathologic characteristics, surgical outcomes, recurrence, and 5-year recurrence-free survival were evaluated.The mean age of the patients was 58.6 years. Thirty patients (2.8%) had distant metastasis preoperatively. Median tumor size was 4.0 cm. Complete resection (R0 resection) was achieved in 1018 patients (96.3%). Eighty-six patients (8.1%) had postoperative complications, and 2 patients (0.2%) died within 30 days after surgery. According to the 7th UICC/AJCC TNM system, 5-year recurrence-free survival rates were 95% to 99% in stage I, 94.1% in stage II, 74.1% in stage IIIA, 48.6% in stage IIIB, and 50.0% in stage IV patients. On survival analysis of high-risk patients according to the TNM system, the 5-year recurrence-free survival rates were 91.6% in stage II, 74.1% in stage IIIA, and 48.6% in stage IIIB patients. Independent factors of recurrence following surgery for gastric GIST were gender, tumor size, mitotic count, and radicality on multivariate analysis.The treatment outcome and prognosis of gastric GIST in Korea and Japan seem more favorable compared to those in Western countries. Compared to the modified NIH risk classification, the 7th UICC/AJCC TNM system is more reflective of the 5-year recurrence-free survival of patients with gastric GIST.
authors.affiliation: From the Department of Surgery, Dong-A University College of Medicine, Seoul, Korea (M-CK, K-HK); Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea (J-HY, M-WY); Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea (H-KY, H-JL); Department of Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea (T-SS); Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea (W-JH); Department of Surgery, Keimyung University School of Medicine, Seoul, Korea (S-WR); Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Seoul, Korea (YK); Center for Gastric Cancer, National Cancer Center, Seoul, Korea (Y-WK); Department of Surgery, School of Medicine, Ajou University, Seoul, Korea (S-UH); Department of Surgery, Seoul National University Bundang Hospital, Seoul, Korea (H-HK, D-JP); Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Cathoilc University of Korea, Seoul, Korea (WK); Department of Surgery, Chungnam National University Hospital, Seoul, Korea (S-IL); Department of Gastrointestinal Surgery, Kanagawa Cancer center, Seoul, Korea (HC); Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea (G-SC); and Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (J-JK).
authors.forename: Min-Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Yook
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Tae-Sung
authors.initials: TS
authors.lastname: Sohn
authors.forename: Woo-Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Seung-Wan
authors.initials: SW
authors.lastname: Ryu
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Han
authors.forename: Hyung-Ho
authors.initials: HH
authors.lastname: Kim
authors.forename: Do-Joong
authors.initials: DJ
authors.lastname: Park
authors.forename: Wook
authors.initials: W
authors.lastname: Kim
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Lee
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Cho
authors.forename: Gyu-Seok
authors.initials: GS
authors.lastname: Cho
authors.forename: Jin-Jo
authors.initials: JJ
authors.lastname: Kim
authors.forename: Ki-Han
authors.initials: KH
authors.lastname: Kim
authors.forename: Moon-Won
authors.initials: MW
authors.lastname: Yoo
mesh_terms: D001837:Body Weights and Measures; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate