Researchers in China identified independent prognostic indicators for gastrointestinal stromal tumors (GISTs) and published their findings in Medicine. This knowledge may improve accurate risk assessments and allow the use of individualized therapies and better follow-up strategies for patients.

There are many factors affecting the prognosis of GISTs but the main ones are the tumor stage and tumor resectability.

In the present study, a team led by Chen Xin, PhD, from the Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University in China assessed the factors affecting overall survival in patients with primary small intestinal GISTs who have undergone R0 resection.


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The researchers retrospectively analyzed 82 patients with GISTs whose tumors were mainly found in the jejunum (46.3% of cases), duodenum (32.9% of cases), and ileum (20.7% of cases). Tumor sizes ranged between 1 cm and 15 cm. The majority of patients (68.3%) had a mitotic rate of 5 or less.

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The team found that the size and rupture of the tumor, the Ki67 and mitotic index, and the use of imatinib following surgery were independent prognostic factors for small intestinal GISTs.

Patients with tumors bigger than 10 cm, a mitotic index of more than 5, whose tumor has ruptured, and who have a high Ki67 positive index should be more closely followed up, the authors said.

Because adjuvant treatment with imatinib is necessary for patients with intermediate and high-risk recurrence following surgery, the researchers suggest that “secondary prevention should be performed as soon as possible after surgery for patients with the above risk factors” for a better prognosis. They also suggest that more attention should be given to the relationship between tumor rupture and the Ki67 index with a poor prognosis.

GISTs are rare soft-tissue tumors that develop from the interstitial cells of Cajal that can occur anywhere in the gastrointestinal tract including the small intestine. 

Reference

Qu H, Xu Z, Ren Y, et al. The analysis of prognostic factors of primary small intestinal gastrointestinal stromal tumors with R0 resection: a single-center retrospective study. Medicine (Baltimore). 2022;101(25):e29487. doi:10.1097/MD.0000000000029487