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Re‐appraisal of the universal definition of tumor rupture among patients with high‐risk gastrointestinal stromal tumors

Gotohda, Naoto ; Nishida, Toshirou ; Sato, Shinsuke ; Ozaka, Masato ; Nakahara, Yujiro ; Komatsu, Yoshito ; Kondo, Masato ; Cho, Haruhiko ; Kurokawa, Yukinori ; Kitagawa, Yuko

Annals of Gastroenterological Surgery, 2023-11, Vol.7 (6), p.1021-1031 [Periódico revisado por pares]

Hoboken: John Wiley & Sons, Inc

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  • Título:
    Re‐appraisal of the universal definition of tumor rupture among patients with high‐risk gastrointestinal stromal tumors
  • Autor: Gotohda, Naoto ; Nishida, Toshirou ; Sato, Shinsuke ; Ozaka, Masato ; Nakahara, Yujiro ; Komatsu, Yoshito ; Kondo, Masato ; Cho, Haruhiko ; Kurokawa, Yukinori ; Kitagawa, Yuko
  • Assuntos: Adjuvant treatment ; Cancer ; Comparative analysis ; gastrointestinal stromal tumor ; high‐risk GIST ; Medical research ; Medicine, Experimental ; Original ; Risk factors ; Surveys ; tumor rupture ; Tumors ; universal definition
  • É parte de: Annals of Gastroenterological Surgery, 2023-11, Vol.7 (6), p.1021-1031
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Aim Tumor rupture has been indicated as a risk factor for recurrence of gastrointestinal stromal tumors (GISTs). The universal definition of tumor rupture was proposed. This study evaluated whether the universal definition was more accurate in identification of GISTs with high recurrent risk than subjective judgment. Methods The study included 507 patients with high‐risk GISTs who underwent complete resection between December 2012 and December 2015. We conducted a questionnaire survey in participating institutes to re‐diagnose tumor rupture based on the universal definition according to their surgical and pathological findings. We compared the clinical outcomes of tumor rupture based on the definition to those based on the surgeon's judgment and clarified the clinical importance of the rupture. Results Sixty‐four patients were initially registered to have tumor rupture by surgeon's judgment, and it became 90 patients who had tumor rupture after reevaluation. Although there were significant differences in recurrence‐free survival (RFS) between no rupture and rupture for both initial registration and reevaluation (p = 0.002, <0.001, respectively), a significant difference in overall survival was only observed after reevaluation (p = 0.011). Tumor rupture was significantly associated with large tumor size, mixed cell type in histology, R1 resection, frequent adjuvant therapy and recurrence, but not with location, mitosis, and genotype. Adjuvant therapy more than 3 years improved RFS of patients with tumor rupture. Conclusion This study suggested that tumor rupture based on the universal definition more accurately identified GISTs with poor prognostic outcomes than the subjective judgment. Overall survival (OS) was not different between non‐tumor rupture (NTR) and tumor rupture (TR) groups in the initial report (p = 0.210). The 3‐year/5‐year OS rates of NTR and TR groups were 97.9/93.1% (NTR, 3y/5y) and 96.7/85.4% (TR, 3y/5y), respectively. In contrast, OS was significantly different between the two groups in the reevaluated report (p = 0.011).
  • Editor: Hoboken: John Wiley & Sons, Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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