As primary tumor sizes and mitotic indexes increase in gastrointestinal stromal tumors (GISTs), prognoses become worse, according to new research published in the Nigerian Journal of Clinical Practice.

Researchers found that patients had a significantly lower 5-year overall survival (OS) rate if they had a primary tumor diameter greater than 5 cm (P =.024), a mitotic index above 5/50 high power field (HPF; P =.038), or were in a high-risk group in the National Institutes of Health prognostic criteria (P =.011).

Similar findings were also found for mean OS and disease-free survival (DFS) rates for diameters larger than 5 cm (P =.005 and P =.004, respectively), mitotic index greater than 5/50 HPF (P =.023 and P =.008, respectively), and the high-risk group (P =.012 and P <.001, respectively).


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When correlation analysis was applied to the data, the tumor diameter was found to be significantly and inversely correlated with OS (P =.034; r =-.317). In terms of DFS, both tumor diameter (P =.004; r =-.425) and mitotic index (P =.035; r =-.316) measures were inversely correlated.

“With these findings, it was found that the tumor diameter, mitotic index and the risk classification based on these parameters can be used as reliable predictors in determining the prognosis in these cases,” the authors said.

A total of 64 patients with GIST were reviewed over a 10-year period (2010-2020) from a single clinical site for the study. All patients came to the clinical site for resection surgery. Women made up 57.8% of the patient group.

The most commonly reported symptoms for the patients were pain (59.4%) and bleeding (17.2%), while 15.6% of patients remained asymptomatic. A total of 56.3% of patients had a primary tumor of 5 cm or larger and 25% of patients had a mitotic index above 5/50. 

Reference

Uzunoglu H, Tosun Y, Akinci O, Baris B. Gastrointestinal stromal tumors of the stomach: a 10-year experience of a single-center. Niger J Clin Pract. 2021;24(12):1785-1792. doi:10.4103/njcp.njcp_558_20