title: Clinicopathological Characteristics, Surgery and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumors.
abstract: BACKGROUND
  Duodenal gastrointestinal stromal tumors (GISTs) are a rare subset of GISTs (3-5%), and their clinicopathological features have not been fully described. The purpose of this retrospective study was to examine these characteristics and compare the operative procedures.
  
  
  METHODS
  Twenty-five patients with duodenal GIST underwent complete resection, local resection (LR) or pancreaticoduodenectomy (PD) from 1990 to 2014 at our 2 hospitals. We analyzed patient characteristics, treatments, histological examinations, postoperative complications and survival outcomes.
  
  
  RESULTS
  Twelve patients (48%) with no symptoms were incidentally diagnosed for unrelated reasons. Sixteen patients (64%) had c-kit mutations while 6 (24%) were wild-type, including 4 with a history of neurofibromatosis type 1. Comparing LR (n = 16) and PD (n = 9), the recurrence-free survival rate was significantly worse for PD. On multivariate analysis, however, tumor size was an independent and significant prognostic factor, but not operative procedure. There was no body weight change with LR, but body weight decreased by 7% with PD.
  
  
  CONCLUSIONS
  Duodenal GISTs had different characteristic genetic mutations compared to other GISTs. LR for duodenal GISTs appears to be oncologically and nutritionally feasible.
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Sugase
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.forename: Toru
authors.initials: T
authors.lastname: Masuzawa
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Tomoki
authors.initials: T
authors.lastname: Makino
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004386:Duodenum / Q000473:pathology* / Q000601:surgery; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D019009:Proto-Oncogene Proteins c-kit