Long-term surgical outcome of 1057 gastric GISTs according to 7th UICC/AJCC TNM system: Multicenter observational study from Korea and Japan

Min Chan Kim, Jeong Hwan Yook, Han Kwang Yang, Hyuk Joon Lee, Tae Sung Sohn, Woo Jin Hyung, Seung Wan Ryu, Yukinori Kurokawa, Young Woo Kim, Sang Uk Han, Hyung Ho Kim, Do Joong Park, Wook Kim, Sang Il Lee, Haruhiko Cho, Gyu Seok Cho, Jin Jo Kim, Ki Han Kim, Moon Won Yoo

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Abstract

The aim of this study was to evaluate the treatment and prognosis of gastric gastrointestinal stromal tumors (GISTs) according to the 7th UICC/AJCC tumor-node-metastasis (TNM) system and the modified National Institutes ofHealth (NIH) risk classification. The study cohort consisted of 1057 patients with gastric GIST who underwent surgery between January 2000 and December 2007 from 13 institutions in Korea and 2 in Japan. Clinicopathologic characteristics, surgical outcomes, recurrence, and 5-year recurrence-free survival were evaluated. The mean age of the patients was 58.6 years. Thirty patients (2.8%) had distant metastasis preoperatively. Median tumor size was 4.0 cm. Complete resection (R0 resection) was achieved in 1018 patients (96.3%). Eighty-six patients (8.1%) had postoperative complications, and 2 patients (0.2%) died within 30 days after surgery. According to the 7th UICC/AJCC TNMsystem, 5-year recurrence-free survival rates were 95% to 99% in stage I, 94.1% in stage II, 74.1% in stage IIIA, 48.6% in stage IIIB, and 50.0% in stage IV patients. On survival analysis of highrisk patients according to the TNM system, the 5-year recurrence-free survival rates were 91.6% in stage II, 74.1% in stage IIIA, and 48.6% in stage IIIB patients. Independent factors of recurrence following surgery for gastric GIST were gender, tumor size, mitotic count, and radicality on multivariate analysis. The treatment outcome and prognosis of gastric GIST in Korea and Japan seem more favorable compared to those in Western countries. Compared to the modified NIH risk classification, the 7th UICC/AJCC TNM system is more reflective of the 5-year recurrence-free survival of patients with gastric GIST.

Original languageEnglish
Article numbere1526
JournalMedicine (United States)
Volume94
Issue number41
DOIs
Publication statusPublished - 2015

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Kim, M. C., Yook, J. H., Yang, H. K., Lee, H. J., Sohn, T. S., Hyung, W. J., Ryu, S. W., Kurokawa, Y., Kim, Y. W., Han, S. U., Kim, H. H., Park, D. J., Kim, W., Lee, S. I., Cho, H., Cho, G. S., Kim, J. J., Kim, K. H., & Yoo, M. W. (2015). Long-term surgical outcome of 1057 gastric GISTs according to 7th UICC/AJCC TNM system: Multicenter observational study from Korea and Japan. Medicine (United States), 94(41), [e1526]. https://doi.org/10.1097/MD.0000000000001526