Surgical Margin Status and Prognosis of Gastrointestinal Stromal Tumor
Surgical Margin Status and Prognosis of Gastrointestinal Stromal Tumor
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DOI：
10.1007/s00268-008-9704-8
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发表时间：
2008-11-01
影响因子：
2.6
通讯作者：
Lopes, Jose M.
中科院分区：
文献类型：
--
作者：
Gouveia, Antonio M.;Pimenta, Amadeu P.;Lopes, Jose M.
背景手术是原发性胃肠道间质瘤的最佳治疗方法，可能是治愈性的，但切除范围/完整性对预后的影响仍存在争议。作者的目的是评估临床病理参数和手术切缘状态对GIST患者预后的影响。采用单因素分析（UA）和多因素分析（MA）方法，分析CP参数对无复发生存期（RFS）和疾病特异性生存期（DSS）的影响。96例肉眼完全切除：78例R 0手术切缘状态，18例R1。R 0组的复发率（12.5%）（9.0%）显著低于R1组（27.8%）。肿瘤> 10 cm、有丝分裂计数> 5/50高倍视野（HPF）和高危GIST预测RFS和DSS（UA）较差。肉眼不完全切除（R2）后，混合细胞形态和坏死肿瘤（UA）的疾病特异性生存期明显缩短。高危GIST（p = 0.016）和R2切除（p = 0.013）预测患者的DSS较差（MA）。结论高危GIST和肉眼切缘阳性是GIST患者疾病特异性生存率较差的相关因素。
Background Surgery is the best treatment for primary GIST and may be curative, but resection extension/completeness impact on the prognosis remains controversial. The authors aim was to evaluate the clinicopathological (CP) parameters and surgical margins status influence on GIST patients' outcome.Materials and methods The study evaluated 113 consecutive patients with sporadic GIST; the influence of CP parameters on recurrence-free survival (RFS) and disease-specific survival (DSS) was determined by univariate analysis (UA) and multivariate analysis (MA).Results Of 104 cases, macroscopically complete resection was achieved in 96: R0 surgical margin status in 78 and R1 in 18. Recurrence rates (12.5%) were significantly lower in R0 (9.0%) than in R1 (27.8%). Tumor > 10 cm, mitotic count > 5/50 high power field (HPF), and high-risk GIST predicted poor RFS and DSS (UA). Disease-specific survival was significantly shorter after macroscopic incomplete (R2) resection, for mixed cellular morphology, and in tumors with necrosis (UA). High-risk GIST (p = 0.016) and R2 resection (p = 0.013) predicted poor DSS of patients (MA).Conclusions High risk and positive macroscopic surgical margin status are parameters associated with poor disease-specific survival in GIST patients.