Prognostic analysis of gastric gastrointestinal stromal tumor with synchronous gastric cancer
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Prognostic analysis of gastric gastrointestinal stromal tumor with synchronous gastric cancer Mi Lin, Jian-Xian Lin, Chang-Ming Huang*, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang and Jun Lu
Abstract Background: Many patients with gastric gastrointestinal stromal tumor (GIST) and synchronous gastric cancer have been described, most in single case studies. We retrospectively investigated the clinicopathologic features and prognostic effects of gastric GIST in patients with synchronous gastric cancer. Methods: The study enrolled 170 patients with gastric GIST, who had undergone complete surgical resection (R0) from January 2000 to December 2011. Forty-two patients had synchronous gastric cancer (CA Group), whereas 128 did not (Non-CA Group). The clinicopathologic features and potential prognostic factors in the two groups were compared. Results: Patients in the CA Group had more obvious symptoms, but a lower rate of preoperative diagnosis of gastric GIST (P 10/50 HPF
10(7.8)
1(2.4)
Very low
17(13.3)
35(83.3)
Low
54(42.2)
4(9.5)
Intermediate
27(21.1)
2(4.8)
High
30(23.4)
1(2.4)
7(5.5)/121(94.5)
1(2.4)/41(97.6)
10(.8)/118(92.2)
0(0.0)/42(100.0)
Tumor bleeding Yes/No Tumor ulceration Yes/No
0.014*
Mitotic count
Risk stratification
0.000*
Tumor necrosis Yes/No Cystic tumor Yes/No CD117 (−)/(+)
0.009* 19(14.8)/109(85.2)
14(33.3)/28(66.7)
CD34 (−)/(+)
0.000* 11(8.6)/117(91.4)
17(40.5)/25(59.5)
82(64.1)/46(35.9)
30(71.4)/12(28.6)
116(90.6)/12(9.4)
38(90.5)/4(9.5)
18(14.1)/110(85.9)
9(21.4)/33(78.6)
SMA (−)/(+) S-100 (−)/(+) Postoperative complications Yes/No
*Analysis of variance. P 60
*Analysis of variance. P 10
54(77.3)/76(92.5)/24(78.4)/ 16(63.3)
Tumor bleeding Yes/No
16(100.0)/154(80.1)
Tumor ulceration Yes/No
40(92.3)/130(78.4)
Mitotic count (/50 HPF) ≤ 5/>5 to 10/>10
135(86.1)/24(67.9)/11(70.7)
Survival analysis based on risk stratification
Risk stratification
0.004*
The 5-year survival rates were significantly lower among patients with synchronous gastric cancer than among patients without synchronous gastric cancer, both among patients stratified as being at very low risk/low risk (60.2% versus 98.6%, P
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