Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study

作     者：Tao Chen Liang-Ying Ye Xing-Yu Feng Hai-Bo Qiu Peng Zhang Yi-Xin Luo Li-Yi Yuan Xin-Hua Chen Yan-Feng Hu Hao Liu Yong Li Kai-Xiong Tao Jiang Yu Guo-Xin Li 

作者机构：Department of General SurgeryNanfang HospitalSouthern Medical University Department of GastroenterologyNanfang HospitalSouthern Medical University Department of General SurgeryGuangdong General HospitalGuangdong Academy of Medical Sciences Department of Gastric SurgerySun Yat-sen University Cancer CenterSun Yatsen University Department of General SurgeryWuhan Union HospitalHuazhong University of Science and Technology 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第10期

页      面：1238-1247页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：the State Key Project of Research and Development Plan,No.2017YFC0108300 and No.2017YFC0108303 2018 Special Funds for the Cultivation of Guangdong College Students'Scientific and Technological Innovation(Climbing Program Special Funds),No.pdjha0094 

主　　题：Gastrointestinal stromal tumors Risk stratification Prognosis Modified National Institute of Health criteria Armed Forces Institute of Pathology criteria Memorial Sloan Kettering Cancer Center prognostic nomogram Contour maps Gastrointestinal tumors 

摘      要：BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To evaluate the application value of four different risk stratification systems for GISTs.METHODS Patients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health(NIH)criteria, the Armed Forces Institute of Pathology(AFIP) criteria, the Memorial Sloan Kettering Cancer Center(MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic(ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve(AUC).RESULTS A total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields(HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size 5 cm(P 5/50 HPFs(P 0.05), non-gastric location(P 0.05), and tumor rupture(P 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC(0.754).CONCLUSION According to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs.