Clinicopathological Features and Prognosis of Primary GISTs with Tumor Rupture in the Real World.
Clinicopathological Features and Prognosis of Primary GISTs with Tumor Rupture in the Real World.
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DOI：
10.1245/s10434-018-6505-7
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发表时间：
2018-07
影响因子：
3.7
通讯作者：
Kinki GIST Study Group
中科院分区：
文献类型：
--
作者：
Nishida T;Cho H;Hirota S;Masuzawa T;Chiguchi G;Tsujinaka T;Kinki GIST Study Group
破裂的胃肠道间质瘤（GIST）患者推荐使用伊马替尼辅助治疗;然而，伊马替尼时代的临床病理特征和预后尚不清楚。研究队列包括665例经组织学证实的原发性GIST患者，他们在2003年至2007年间接受了R 0或R1手术;验证队列包括2000年至2014年间的182例患者。本研究中肿瘤破裂的定义包括肿瘤部位穿孔、肿瘤破裂、包括开放性活检在内的部分切除和假包膜的肉眼可见损伤。在研究和验证队列中，分别有21/665（3.2%）和5/182（2.9%）例患者发生肿瘤破裂。破裂的GIST比未破裂的GIST更有症状，体积更大，有丝分裂计数更高，但与肿瘤位置或腹腔镜手术无关。GIST术中破裂的临床病理特征和预后结果与术前破裂相似。破裂型GIST的复发率高于非破裂型GIST，中位无复发生存期（RFS）和总生存期（OS）较短。多因素分析显示，肿瘤破裂是RFS的独立预后因素之一，而不是OS。破裂的GIST是有症状的较大肿瘤，具有高有丝分裂活性，频繁复发和较短的RFS。在伊马替尼时代，肿瘤破裂是RFS的独立预后因素，但不是OS的独立预后因素。本文的在线版本（10.1245/s10434-018-6505-7）包含补充材料，可供授权用户使用。
Patients with ruptured gastrointestinal stromal tumor (GIST) are recommended for imatinib adjuvant therapy; however, their clinicopathological features and prognosis in the era of imatinib are unknown. The study cohort included 665 patients with histologically proven primary GISTs who underwent R0 or R1 surgery between 2003 and 2007; the validation cohort included 182 patients between 2000 and 2014. The definitions of tumor rupture in the study included perforation at tumor site, tumor fracture, piecemeal resection including open biopsy, and macroscopic injuries to the pseudocapsule. Tumor rupture occurred in 21 (3.2%) of 665 and 5 (2.9%) of 182 patients in the study and validation cohort, respectively. Ruptured GISTs were more symptomatic, were larger in size, and had higher mitotic count than nonruptured GISTs but were not associated with tumor location or laparoscopic surgery. GISTs with intraoperative rupture had clinicopathological features and prognostic outcomes similar to those with preoperative rupture. Recurrence rates were higher and median recurrence-free survival (RFS) and overall survival (OS) were shorter with ruptured than nonruptured GIST. Tumor rupture was one of the independent prognostic factors for RFS, but not OS, according to multivariate analysis. Ruptured GISTs were symptomatic larger tumors with high mitotic activity, frequent relapse, and shorter RFS. Tumor rupture was an independent prognostic factor for RFS, but not for OS, in the era of imatinib. The online version of this article (10.1245/s10434-018-6505-7) contains supplementary material, which is available to authorized users.
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影响因子：
9
作者：
DeMatteo RP;Ballman KV;Antonescu CR;Corless C;Kolesnikova V;von Mehren M;McCarter MD;Norton J;Maki RG;Pisters PW;Demetri GD;Brennan MF;Owzar K;American College of Surgeons Oncology Group (ACOSOG) Intergroup Adjuvant GIST Study Team for the Alliance for Clinical Trials in Oncology
通讯作者：
American College of Surgeons Oncology Group (ACOSOG) Intergroup Adjuvant GIST Study Team for the Alliance for Clinical Trials in Oncology
DOI：
10.1007/s11605-014-2658-2
发表时间：
2014-12
期刊：
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
影响因子：
--
作者：
Bischof DA;Kim Y;Behman R;Karanicolas PJ;Quereshy FA;Blazer DG 3rd;Maithel SK;Gamblin TC;Bauer TW;Pawlik TM
通讯作者：
Pawlik TM
影响因子：
3.7
作者：
Goh, Brian K. P.;Chow, Pierce K. H.;Wong, Wai-Keong
通讯作者：
Wong, Wai-Keong
影响因子：
5.9
作者：
Kim, Jin Sil;Kim, Hyun Jin;Ha, Hyun Kwon
通讯作者：
Ha, Hyun Kwon
影响因子：
45.3
作者：
Casali, Paolo G.;Le Cesne, Axel;Blay, Jean-Yves
通讯作者：
Blay, Jean-Yves