title: [Prognostic analysis of gastrointestinal stromal tumors complicated with gastrointestinal bleeding].
abstract: OBJECTIVE
  To study the relationship between clinicopathological characteristics, prognosis and gastrointestinal bleeding in primary gastrointestinal stromal tumors (GIST).
  
  
  METHODS
  The clinicopathological and follow-up data of 200 patients with gastrointestinal stromal tumors treated in our hospital from April 2008 to December 2014 were retrospectively reviewed. The correlation of gastrointestinal bleeding with gastrointestinal stromal tumor clinicopathological characteristics and prognosis were analyzed.
  
  
  RESULTS
  The 200 GIST patients were divided into two groups according to the bleeding in the digestive tract, including 57 gastrointestinal bleeding patients and 143 non-bleeding patients. The mean tumor diameter was 6.5 cm (range 1.8-22 cm) in the bleeding group and 2.5 cm (range 0.4-18 cm) in the non-bleeding group (P<0.05). Of the 57 bleeding patients, 31 located in the stomach, 25 in the small intestine, and one had colorectal bleeding. Fifty patients had mitotic index (MI) ≤ 5/50 HPF, other 6 patients ranged between 5 and 10/50 HPF and one patient had MI >10/50 HPF. Six GIST patients were complicated with tumor rapture. But in the non-bleeding group, 125 patients had gastric GIST, 8 in the small intestine, one colorectum, and 9 had esophageal or other GIST. 141 patients had MI ≤5/50 HPF, 1 patients ranged between 5 and 10/50 HPF and one patient had MI >10/50 HPF. Only 1 GIST patients was complicated with tumor rapture. The gastrointestinal bleeding was closely associated with tumor size, mitotic index, tumor location, risk classifications, tumor rapture and tumor recurrence (P<0.05 for all). The 3-year and 5-year survival rates of the 200 patients were 96.5% and 86.8%, respectively. 16 patients developed recurrence or metastasis, and 11 died of GIST. The 5-year survival rate of patients with gastrointestinal bleeding was 76.2%, significantly lower than that of patients without gastrointestinal bleeding (91.6%, P<0.05).
  
  
  CONCLUSIONS
  GIST patients complicated with gastrointestinal bleeding have poor prognosis, and attention should be paid to stratifying patients for therapy.
authors.affiliation: Department of General Surgery, the General Hospital of Tianjin Medical University, Tianjin 300052, China.
authors.forename: R T
authors.initials: RT
authors.lastname: Li
authors.affiliation: Department of General Surgery, the General Hospital of Tianjin Medical University, Tianjin 300052, China.
authors.forename: G J
authors.initials: GJ
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, the General Hospital of Tianjin Medical University, Tianjin 300052, China.
authors.forename: W H
authors.initials: WH
authors.lastname: Fu
authors.affiliation: Department of General Surgery, the General Hospital of Tianjin Medical University, Tianjin 300052, China.
authors.forename: W D
authors.initials: WD
authors.lastname: Li
mesh_terms: D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000401:mortality; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000401:mortality / Q000473:pathology; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology; D015996:Survival Rate