The effect of surgery and grade on outcome of gastrointestinal stromal tumors
The effect of surgery and grade on outcome of gastrointestinal stromal tumors
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DOI：
10.1001/archsurg.136.4.383
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发表时间：
2001-04-01
影响因子：
--
通讯作者：
Ott, MJ
中科院分区：
文献类型：
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作者：
Pierie, JPEN;Choudry, U;Ott, MJ
假设：胃肠道间质瘤（GIST）是一种侵袭性、罕见且难以根治的胃肠道肿瘤。我们认为，这些肿瘤的临床行为可以预测的可重复的预后factors.Design和设置：一个回顾性分析的所有患者（N = 70）与GIST治疗在一个三级保健中心，从1973年至1998.Patients：足够的数据进行评估69例。男女比例为40：29。中位年龄为60岁。随访时间中位数为38个月。主要结果测量：肿瘤分级、分期和组织学亚型;分级、手术和辅助治疗对复发、挽救和生存的影响。下消化道16%，中位肿瘤大小为7.9 cm（范围：1.8-25 cm）。每10个高倍视野中有超过1个有丝分裂的肿瘤占该系列肿瘤的57%。49%的患者在初次访视时发生远处疾病。59%的患者发生了完全大体切除。完全切除后的5年生存率为42%，而不完全切除后的5年生存率为9%（风险比=0.27，P
Hypothesis: Gastrointestinal stromal tumors (GIST) are aggressive, rare, and difficult-to-curt gastrointestinal turners. We believe that the clinical behavior of these tumors can be predicted by reproducible prognostic factors.Design and Setting: A retrospective review of all patients (N = 70) with GIST treated at a tertiary care center from 1973 to 1998.Patients: Adequate data for evaluation were available for 69 patients. Male-female distribution was 40:29. Median age was 60 years. Median follow-up duration was 38 months.Main Outcome Measures: Tumor grade, stage, and histologic subtype at presentation; effect of grade, surgery and adjuvant therapy on recurrence, salvage, and survival.Results: Tumor distribution included 61% in the upper, 23%;, in the middle, and 16% in the lower digestive tract, with a median tumor size of 7.9 cm (range, 1.8-25 cm). Tumors with more than 1 mitosis per 10 high-power fields constituted 57% of neoplasia in the series. Distant disease at initial visit occurred in 49% of patients. Complete gross resection occurred in 59% of patients. After complete resection, the 5-year survival rate was 42%, compared with 9% after incomplete resection (hazard ratio=0.27, P