scholarly journals Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shao-jun Xu ◽  
Si-yu Zhang ◽  
Ling-yi Dong ◽  
Guo-sheng Lin ◽  
Yong-jian Zhou
Keyword(s):  
Prognostic Factors ◽  
Survival Time ◽  
Mitotic Index ◽  
Gastrointestinal Stromal Tumors ◽  
Disease Free Survival ◽  
Chinese Patients ◽  
Conditional Survival ◽  
Cox Regression Analysis ◽  
Stromal Tumors

Abstract Background The prognosis of patients with gastrointestinal stromal tumors (GISTs) is generally evaluated at the time of diagnosis but does not reflect the survival dynamics of patients in the future. Therefore, the purpose of this article was to evaluate the conditional survival (CS) of Chinese patients with GISTs after radical resection. Methods This retrospective study included 451 patients who underwent radical surgery for GISTs. A Cox proportional hazard model was used to evaluate the prognostic factors of disease-free survival (DFS). The 3-year conditional DFS (CDFS3) of patients who survived for x years was expressed as CDFS3=DFS(x + 3)/DFS(x). Results The traditional 3-year DFS rate decreased gradually from 94.0% at 3 years to 77.3% at 7 years, while the CDFS3 rate increased from 94.0 to 95.2% over the survival time of the patients. In addition, classic clinicopathological prognostic factors had different effects on CDFS3, with changes observed in survival time, but these effects were only slight or moderate (|d|<0.5). Although multivariate analysis showed that age, sex, mitotic index and tumor rupture were independent risk factors for DFS at baseline, all adverse prognostic factors, except for the mitotic index, lost their predictive significance at 5 years after operation. When the Modified NIH criteria were included, the risk staging was found to be an independent risk factor for recurrence or death. Time-dependent Cox regression analysis showed that the modified NIH criteria independently affected the recurrence or death of GIST patients within 2 years after operation. Conclusion CS provides detailed dynamic survival information about Chinese patients with primary resected GISTs. The mitotic index is of great clinical significance for the monitoring and follow-up of patient populations with a high risk of tumor recurrence or death until 5 years after surgery.

CLINICO-PATHOLOGICAL AND RADIOLOGICAL PROGNOSTIC FACTORS IN CANCER CERVIX TREATED WITH CONCURRENT CHEMORADIATION

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Manraj S. Kang ◽  
Kamal Sahni ◽  
Piyush Kumar ◽  
Rajneesh Madhok ◽  
Ratna Saxena ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mitotic Index ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Concurrent Chemoradiation ◽  
P Value ◽  
Publication Date ◽  
Cancer Cervix ◽  
Stage Ib

<bold>Introduction:</bold> Cervical cancer is most common cancer in the rural and second most common in urban areas of our country. It accounts for 16% of all cancers. There are various clinical, Paper Submission Datepathological and radiological factors which dictate the prognosis of these cancer cervix patients. The present study evaluates clinical, pathological and radiological prognostic factors in cancer cervix treated with concurrent chemoradiation. <bold>Material and Methods:</bold> A total of 32 patients seen between 2012 and 2014 patients planned concurrent chemoradiation were evaluated in terms of clinical (age, stage, Hb% and HPV Paper Publication Date infection), pathological (histopathology type and subtype, grade, mitotic index, lymph-July 2016 vascular invasion and necrosis) and radiological (parametrial extension, disease dimension, lymph node, hydronephrosis and vascularity of tumour) prognostic factors. After pre-DOI treatment evaluation patient was planned for 3 Dimentional-Conformal Radiotherapy (50Gy/25#/5 weeks) with concurrent chemotherapy (Cisplatin 35mg/m<sup>2</sup>) followed by 3 applications of Intracavitary radiotherapy (6Gy/fraction) with 6 months follow up. Response was accessed according to WHO response criteria and univariate analysis was done using chi-square test. <bold>Results:</bold> Clinical factors: Age – better disease free survival in older patients (p value=0.003), stage - Lower stage had better survival (for stage Ib-IIa vs stage IIb p value = 0.003 and for stage Ib vs. IIIb p value = 0.0005), Hb% - 57% patients with Hb <10g/dl had recurrence at end of 6 months (p value=0.00001), HPV – High recurrence with HPV presence. Pathological factors like high Mitotic Index had more residual disease (p=0.0009), grade - No statistical significance. Radiological factors- volume of disease - 35 % patients with volume of disease > 6 cm had disease at end of 6 months, hydronephrosis - 40 % patient with hydronephrosis had recurrence (p value = 0.0005) at end of 6 months follow up and vascularity of tumour showed statistically no difference. <bold>Conclusion:</bold> Hb <10%, HPV infection, Mitotic index (3-5/HPF), stage IIIB, pelvic nodes were concluded as the independent poor prognostic factors.

Gastrointestinal Stromal Tumors: Actin Expression, a New Prognostic Factor?

2010 ◽  
Vol 76 (11) ◽  
pp. 1244-1250 ◽  
Author(s):  
Jaime Ruiz-Tovar ◽  
María Diez-Tabernilla ◽  
Gada Housari ◽  
Enrique Martinez-Molina ◽  
Alfonso Sanjuanbenito
Keyword(s):  
Prognostic Factors ◽  
Small Bowel ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Mass ◽  
Disease Free Survival ◽  
Gastric Gist ◽  
Free Survival ◽  
Stromal Tumors ◽  
Actin Expression ◽  
Disease Free

The aim of this study is to analyze the clinical outcome of gastrointestinal stromal tumors (GISTs) and to determine new prognostic factors. We perform a retrospective study of all the patients diagnosed with GIST in any location and operated on between 2000 and 2008 at our institution. We analyzed 35 patients, 16 males (45.7%) and 19 females (54.3%), with a mean age of 64 ± 13.8 years. The tumors were located in the stomach in 22 patients (62.9%), in the small bowel in 10 (28.6%), and the retroperitoneum in three (8.6%). Referring to gastric GIST, endoscopy revealed an ulceration in the mucosa in five cases, suggesting an epithelial neoplasm. In all these cases, pathology of the biopsy specimen was nonconclusive. Survival rate at 1 and 5 years was 94.3 and 88.6 per cent, respectively. Disease-free survival at 1 and 2 years was 91.4 and 88.6 per cent, respectively. Analyzing prognostic factors, a lower disease-free survival was observed among patients with constitutional syndrome at diagnosis ( P = 0.000), small bowel GIST ( P = 0.037), and tumors not expressing actin ( P = 0.015). A lower global survival was observed among men ( P = 0,036), patients with an abdominal mass ( P = 0.033) or with constitutional syndrome ( P = 0.007) at diagnosis and tumors at a retroperitoneal location ( P = 0.0002). Gastric GIST may be confused with epithelial neoplasms, modifying the surgery. In our patients, masculine gender, constitutional syndrome and abdominal mass at diagnosis, small bowel and retroperitoneal location, and actin negative tumors are bad prognostic factors.

scholarly journals The prognostic role of Controlling Nutritional Status (CONUT) scores in patients with gastrointestinal stromal tumors

2019 ◽  
Author(s):  
Weili Yang ◽  
Chunhui Shou ◽  
Jiren Yu ◽  
Qing Zhang ◽  
Xiaosun Liu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Nutritional Status ◽  
Mitotic Index ◽  
Tumor Size ◽  
Gastrointestinal Stromal Tumors ◽  
Rank Test ◽  
Primary Tumor Site ◽  
Stromal Tumors ◽  
Common Location ◽  
Conut Score

Abstract Background: The Controlling Nutritional Status (CONUT) score is associated with the postoperative outcomes in various types of tumors. The relationship between the CONUT score and prognosis in patients with gastrointestinal stromal tumors (GISTs) needs to be clarified. Methods: Patients with completely resected primary GISTs in the absence of imatinib adjuvant therapy were included. Recurrence-free survival (RFS) was estimated with the Kaplan-Meier method and compared using log-rank test. Prognostic factors were compared using a Cox proportional hazards model. Results: A total of 455 patients were included. The median age was 57 years and 222 (48.8%) patients were male. The most common location was stomach (n= 219, 48.1%), the median tumor size was 4.5 cm (range 0.4-40.0) and the median mitotic index was 2/50 HPFs (range 0-200). Recurrence/metastasis developed in 92 (20.2%) patients. Patients were assigned to three groups: 219 (48.1%) were in normal nutrition group (CONUT=0-1), 196 (43.1%) were in light undernutrition group (CONUT=2-4) and 40 (8.8%) were in moderate-severe undernutrition group (CONUT≥5). Primary tumor site, tumor size, mitotic index, tumor rupture and CONUT score were independent prognostic factors for RFS using multivariate analysis (p<0.05). Conclusions: The CONUT score was an independent prognostic factor for patients with completely resected GIST.

The long-term outcome of gastrointestinal stromal tumors treatment

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Putticha Keawmanee ◽  
◽  
Wisit Kasetsermwiriya ◽  
Pakkapol Sukhvibul ◽  
Suphakarn Techapongsatorn ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Gastrointestinal Stromal Tumors ◽  
Disease Free Survival ◽  
Mitotic Figure ◽  
R0 Resection ◽  
Long Term Outcome ◽  
Free Survival ◽  
Stromal Tumors ◽  
Disease Free

Background: To evaluate the overall survival, disease free survival, clinicopathological characteristics and prognostic factors of patients with gastrointestinal stromal tumors (GISTs) who were treated at Faculty of Medicine Vajira Hospital. Methods: A retrospective review data of 39 GISTs patients who underwent surgery at Vajira hospital from 2007 to 2011 was performed. The patient characteristics, overall survival, disease-free survival of patients and prognostic factors were evaluated. Results: The median age of patients was 60 years (22-90 years), 54% were female and the main presenting symptom was abdominal pain (33%). Stomach (62%) and small intestine (30%) were the most common locations of tumor respectively. Complete resections (R0) were performed in 31 patients (80% ). All patients (100%) were positive for CD117 and 84.6% for CD34. According to the Armed Forces Institute of Pathology criteria, 56.4% of patients were characterized as a high risk. With a median follow-up time of 46 months (1-139 months). The overall survival and disease-free survival at 5 years were 84.6% and 66.7%, respectively. Two patients received Imatinib in neoadjuvant setting while 10 patients for disease control. Eight patients (20.5%) developed recurrences. R0 resection, mitotic figure and location of tumor were the significant prognostic factors. Conclusions: The overall survival and disease-free survival at 5 years were 84.6% and 66.7%, respectively. R0 resection, mitotic figure and location of tumor were the significant prognostic factors. Keywords: gastrointestinal stromal tumor; gists; prognostic factors; survival.

scholarly journals Outcome and prognostic factors of primary gastrointestinal stromal tumours following complete surgical resection

2019 ◽  
Vol 6 (10) ◽  
pp. 3513
Author(s):  
Mohamed Ebrahim El Dahshan ◽  
Mohamed Ali Mless ◽  
Nehal Mohamed Elmashad ◽  
Hossam Ramadan Moussa ◽  
Ahmed Atia Darwish
Keyword(s):  
Prognostic Factors ◽  
Mitotic Index ◽  
Survival Data ◽  
Gastrointestinal Stromal Tumors ◽  
Tumor Recurrence ◽  
Surgical Excision ◽  
University Hospital ◽  
Definitive Treatment ◽  
Resection Margins ◽  
Stromal Tumors

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms. Surgical excision is the definitive treatment for primary localized GISTs. Targeted therapy represented by tyrosine kinase inhibitors has clearly improved the survival rates in patients with GISTs. The aim of this study was to identify prognostic factors influencing tumor recurrence and survival after curative resection of primary GISTs.Methods: This study was conducted on thirty seven patients with localized primary GIST who were operated on in the Department of General Surgery. Then completed adjuvant therapy in the medical Oncology Department, Faculty of Medicine; Tanta University Hospital, from March 2016 to August 2017. All patients’ data, clinical presentations, radiological and endoscopic data, surgical procedures, complications, and survival data were collected, reviewed and analyzed.Results: The mean age of the studied cases was 53.62 years. 14 patients were males and 23 patients were females. Eleven patients had performance status 2. Abdominal pain was the most common complaint. 4 patients presented with acute intestinal obstruction. Ileum was the most common site (14 cases) followed by stomach (13 cases). We reported four cases of extra-gastrointestinal stromal tumors (EGISTs). According to the mitotic index in studied cases; sixteen patients had mitotic count ˃5/50 HPF. Surgical excision was done in all cases with histopathologically negative resection margins. Thirty three cases showed good complete response without local recurrence or distant metastasis.Conclusions:Performance status of patients, tumor size and mitotic index were independent prognostic predictors for tumor recurrence or metastasis. 

Prognostic Analysis of Refractory Anemia in Adult Patients with Myelodysplasric Syndrome in China.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2465-2465
Author(s):  
Xiao-qin Wang ◽  
Zi-xing Chen ◽  
Shu-chang Chen ◽  
Guo-wei Lin ◽  
Mei-rong Ji ◽  
...  
Keyword(s):  
Platelet Count ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Cox Regression ◽  
Chinese Patients ◽  
Refractory Anemia ◽  
Striking Difference ◽  
Cytogenetic Abnormalities ◽  
Cox Regression Analysis

Abstract Several reports indicated a striking difference in age, chromosome abnormalities and prognosis between Western and Eastern MDS patients, even in the same subtype. The prognostic factors in Chinese MDS patients remain unclear. To investigate the prognostic factors and survival rate in Chinese cases with refractory anemia (RA) in adult MDS based on FAB classification, and to evaluate the applicability of international prognostic scoring system (IPSS) for Chinese MDS-RA patients by comparing with the clinical features of Western cases, Three hundred and seven MDS-RA cases were registered and followed-up in Shanghai, Suzhou and Beijing from 1995 to 2006. The longest follow-up duration was 103 months, and the median follow-up duration was 26.7 months. Kaplan-Meier curve, Log-rank and COX regression model were used to analyze the prognostic factors and survival rate. The median age of 307 MDS-RA cases was 52 years. The frequency of 2 or 3 lineage cytopenias was 85.6%. Abnormal karyotype occurred in 35.7% of all MDS-RA patients. By IPSS cytogenetic risk groups, 165 cases (70.2%) were in the good IPSS cytogenetic subgroup, 44 cases (18.7%) in the intermediate IPSS cytogenetic subgroup and 26 cases (11.1%) in the poor IPSS cytogenetic subgroup. According to IPSS, 20 cases (8.5%) were categorized as low risk, 195 cases (83.0%) as intermediate–I risk and 20 cases (8.5%) as intermediate–II risk. The 1–year, 2–year, 3–year, 4–year and 5–year survival rate were 90.8%, 85.7%, 82.9%, 74.9% and 71.2%, respectively. Fifteen cases (4.9%) transformed to acute myeloid leukemia and the median transformation time was 15.9 months (range 3–102 months). Lower white blood cells count (&lt;1.5 × 109/L), platelet count (&lt;30 × 109/L) and cytogenetic abnormalities were identified as independent prognostic factors by multivariate analysis, while the age (≥65 years), hemoglobin level(&lt;60g/L), IPSS cytogenetic subgroup and IPSS risk subgroup were not independent prognostic factors associated with survival time by COX regression analysis. In summary, Chinese patients were younger and had lower incidence of cytogenetic abnormalities and more severe cytopenias than that of the Western patients. However, the Chinese patients have more favorable prognosis than Western patients do. WBC count, platelet count and karyotype are major prognostic factors for prediction of survival and can be helpful in identifying patients with different prognosis and consequently designing the optimal therapeutic strategies. The present IPSS scores based on conditions of western patients may not be perfectly applicable to MDS-RA patients in Asia and need to be modified.

Multislice imaging of gastrointestinal stromal tumors

2018 ◽  
pp. 3-14
Keyword(s):  
Computed Tomography ◽  
Key Words ◽  
Gold Standard ◽  
Gastrointestinal Stromal Tumors ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Preferential Localization ◽  
Multislice Imaging ◽  
Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

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