Appropriate Follow-Up Strategies for Gastrointestinal Stromal Tumor Patients Based on the Analysis of Recurrent Interval and Patterns.
OBJECTIVE
Previous studies have proposed risk classifications for patients with gastrointestinal stromal tumor (GIST) after resection and have contributed to the prediction of its prognosis. However, optimal postoperative surveillance has not yet been established.


METHODS
We retrospectively analyzed data from 115 GIST patients who experienced recurrence after complete resection. The relationships between clinicopathological characteristics and the first recurrence sites, or time to recurrence (TTR), were investigated. We also compared the characteristics between 2 subgroups based on a TTR of ≤5 or >5 years.


RESULTS
The first recurrence occurred in the abdomen in 114 of 115 patients (99.1%); one case of esophageal GIST recurred in the lung. Gastric and small intestinal GISTs recurred most frequently in the liver or peritoneum, while the most common recurrences of colorectal GISTs were found to be local. Fourteen patients (12.2%) experienced recurrence after >5 years. Smaller tumors and those categorized as lower risk were significantly more frequent in the TTR >5 years group than in the TTR ≤5 years group. In the TTR >5 years group, local recurrence was the most frequent type of recurrence (42.9%).


CONCLUSIONS
Based on abdominal examination, postoperative surveillance after complete resection for primary GISTs may be recommended for >5 years.
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Noriko
N
Wada
Tsuyoshi
T
Takahashi
Yukinori
Y
Kurokawa
Kiyokazu
K
Nakajima
Toru
T
Masuzawa
Rie
R
Nakatsuka
Junji
J
Kawada
Toshirou
T
Nishida
Yutaka
Y
Kimura
Kouji
K
Tanaka
Yasuhiro
Y
Miyazaki
Tomoki
T
Makino
Makoto
M
Yamasaki
Shuji
S
Takiguchi
Masaki
M
Mori
Yuichiro
Y
Doki
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062665:Epidemiological Monitoring; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D055815:Young Adult