Relapse and meeting the modified National Institutes of Health criteria are independent risk factors for gastrointestinal stromal tumors (GIST) with gastrointestinal bleeding, according to a new study published in the journal Surgery.

“Gastrointestinal bleeding is associated with poor prognosis in patients with [GIST], and patients with [GIST] with gastrointestinal bleeding have a worse prognosis. Follow-up should be strengthened for such patients,” wrote Xu Zhaojun, MD, of the Qinghai University in Xining, China, and colleagues.

The researcher set out to analyze the relationship between risk factors and prognosis in patients with GIST with gastrointestinal bleeding. In doing so, they analyzed 246 patients with the disease. The researchers divided the patients into 2 groups based on whether or not they had gastrointestinal bleeding. 

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Before propensity score matching, the postoperative survival and recurrence prediction accuracy of the Modified National Institutes of Health criteria were higher than that of the Armed Forces Institute of Pathology criteria, and the independent risk factors were relapse and meeting the Modified National Institutes of Health criteria and .

After 1-to-1 matching, the general clinical data of patients with gastrointestinal and nongastrointestinal bleeding were balanced. The independent risk factors for prognosis were tumor location and gastrointestinal bleeding.

There was no significant difference between the gastrointestinal and nongastrointestinal bleeding groups based on the anatomical site of the tumor.

Patients with GIST with gastrointestinal bleeding had a worse prognosis independently of the anatomical location of the tumor and the different Modified National Institutes of Health criteria.

GIST is a type of rare soft-tissue tumor that develops from the nerve cells located in the wall of the gastrointestinal tract. The first-line treatment for localized GIST is surgical excision, but around 10% of tumors recur after surgery. Long-term follow-up care is essential for patients with GIST.


Zhaojun X, Xiaobin C, Pengfei L, et al. Analysis of risk factors and prognostic factors for gastrointestinal stromal tumors with gastrointestinal hemorrhage: based on propensity score matching method. Surgery. Published online November 21, 2022. doi:10.1016/j.surg.2022.10.001