Subgroups of patients with very large gastrointestinal stromal tumors with distinct prognoses: A multicenter study

Noriko Wada, Yukinori Kurokawa, Toshirou Nishida, Tsuyoshi Takahashi, Takahiro Toyokawa, Hiroshi Kusanagi, Seiichi Hirota, Toshimasa Tsujinaka, Masaki Mori, Yuichiro Doki

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12 Citations (Scopus)


Background and Objectives Any gastrointestinal stromal tumors (GISTs) larger than 10 cm are classified as "high risk" according to the modified National Institutes of Health consensus criteria. We conducted a multicenter study to identify a subgroup with moderate prognosis even within the "high-risk" group. Methods We retrospectively collected data on 107 patients with tumors ≥10 cm from a multicenter database of GIST patients. Patients with macroscopic residual lesions or tumor rupture were excluded. The relationship between recurrence-free survival (RFS) and clinicopathological factors was analyzed. Results The median tumor size and mitotic count were 12.5 cm and 8/50 HPF. The RFS rate was 58.5% at 3 years, 52.1% at 5 years. Only mitotic count was an independent prognostic factor of RFS in the multivariate analysis (P = 0.001). The hazard ratio for recurrence in the subgroup with mitotic count >5/50 HPF was 2.91 (95% confidence interval, 1.53 to 5.56). The subgroup with mitotic count ≤5/50 HPF showed significantly better RFS than the mitotic count >5/50 HPF subgroup (P < 0.001). Conclusions Mitotic count is closely associated with outcome in patients with large GISTs. This suggests that the subset of large GISTs with low mitotic counts may be considered as "intermediate-risk" lesions. J. Surg. Oncol. 2014 109:67-70.

Original languageEnglish
Pages (from-to)67-70
Number of pages4
JournalJournal of Surgical Oncology
Issue number2
Publication statusPublished - Feb 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology


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