Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts.
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Average rating
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Star rating
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Authors
Joensuu, HeikkiVehtari, Aki
Riihimäki, Jaakko
Nishida, Toshirou
Steigen, Sonja E
Brabec, Peter
Plank, Lukas
Nilsson, Bengt
Cirilli, Claudia
Braconi, Chiara
Bordoni, Andrea
Magnusson, Magnus K
Linke, Zdenek
Sufliarsky, Jozef
Federico, Massimo
Jonasson, Jon G
Dei Tos, Angelo Paolo
Rutkowski, Piotr
Issue Date
2012-03
Metadata
Show full item recordCitation
Lancet Oncol. 2012, 13(3):265-74Abstract
The risk of recurrence of gastrointestinal stromal tumour (GIST) after surgery needs to be estimated when considering adjuvant systemic therapy. We assessed prognostic factors of patients with operable GIST, to compare widely used risk-stratification schemes and to develop a new method for risk estimation. Population-based cohorts of patients diagnosed with operable GIST, who were not given adjuvant therapy, were identified from the literature. Data from ten series and 2560 patients were pooled. Risk of tumour recurrence was stratified using the National Institute of Health (NIH) consensus criteria, the modified consensus criteria, and the Armed Forces Institute of Pathology (AFIP) criteria. Prognostic factors were examined using proportional hazards and non-linear models. The results were validated in an independent centre-based cohort consisting of 920 patients with GIST. Estimated 15-year recurrence-free survival (RFS) after surgery was 59·9% (95% CI 56·2-63·6); few recurrences occurred after the first 10 years of follow-up. Large tumour size, high mitosis count, non-gastric location, presence of rupture, and male sex were independent adverse prognostic factors. In receiver operating characteristics curve analysis of 10-year RFS, the NIH consensus criteria, modified consensus criteria, and AFIP criteria resulted in an area under the curve (AUC) of 0·79 (95% CI 0·76-0·81), 0·78 (0·75-0·80), and 0·82 (0·80-0·85), respectively. The modified consensus criteria identified a single high-risk group. Since tumour size and mitosis count had a non-linear association with the risk of GIST recurrence, novel prognostic contour maps were generated using non-linear modelling of tumour size and mitosis count, and taking into account tumour site and rupture. The non-linear model accurately predicted the risk of recurrence (AUC 0·88, 0·86-0·90). The risk-stratification schemes assessed identify patients who are likely to be cured by surgery alone. Although the modified NIH classification is the best criteria to identify a single high-risk group for consideration of adjuvant therapy, the prognostic contour maps resulting from non-linear modelling are appropriate for estimation of individualised outcomes.Description
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.Additional Links
http://dx.doi.org/10.1016/S1470-2045(11)70299-6Rights
Archived with thanks to The lancet oncologyae974a485f413a2113503eed53cd6c53
10.1016/S1470-2045(11)70299-6
Scopus Count
Collections
Related articles
- Validation of the Joensuu risk criteria for primary resectable gastrointestinal stromal tumour - the impact of tumour rupture on patient outcomes.
- Authors: Rutkowski P, Bylina E, Wozniak A, Nowecki ZI, Osuch C, Matlok M, Switaj T, Michej W, Wroński M, Głuszek S, Kroc J, Nasierowska-Guttmejer A, Joensuu H
- Issue date: 2011 Oct
- Which is the optimal risk stratification system for surgically treated localized primary GIST? Comparison of three contemporary prognostic criteria in 171 tumors and a proposal for a modified Armed Forces Institute of Pathology risk criteria.
- Authors: Goh BK, Chow PK, Yap WM, Kesavan SM, Song IC, Paul PG, Ooi BS, Chung YF, Wong WK
- Issue date: 2008 Aug
- Physician Underestimation of the Risk of Gastrointestinal Stromal Tumor Recurrence After Resection.
- Authors: Guérin A, Sasane M, Keir CH, Gauthier G, Macalalad AR, Wu EQ, Conley AP
- Issue date: 2015 Sep
- Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study.
- Authors: Chen T, Ye LY, Feng XY, Qiu HB, Zhang P, Luo YX, Yuan LY, Chen XH, Hu YF, Liu H, Li Y, Tao KX, Yu J, Li GX
- Issue date: 2019 Mar 14
- Validation of the MSKCC Gastrointestinal Stromal Tumor Nomogram and Comparison with Other Prognostication Systems: Single-Institution Experience with 289 Patients.
- Authors: Chok AY, Goh BK, Koh YX, Lye WK, Allen JC Jr, Quek R, Teo MC, Chow PK, Ong HS, Chung AY, Wong WK
- Issue date: 2015 Oct