Surgery and prognostic factors for gastric stromal tumor.
World journal of surgery, 25(3):290-295, 2001
World journal of surgery
Morphologic studies of gastric stromal tumors (GSTs) indicate that mitotic counts (MCs) and tumor size are major discriminants predictive of biologic behavior. The purpose of this study is to improve the understanding of GST behavior, including the prognostic factors and surgical treatment of GSTs. A retrospective analysis (1990--1997) of the clinical course for 116 patients with GSTs was completed, with a median follow-up of 43 months. Tumors were categorized as malignant GSTs (n = 17) when the MC was > 5/50 high-power fields (HPF) and the size > 5 cm or as benign GSTs (n = 99) when the MC was < or = 5/50 HPF and the size < or = 5 cm, MC 5 cm, or MC > 5/50 HPF and size 5/50 HPF (p = 0.0001); (2) severe pleomorphism (p = 0.0062); (3) necrosis (p = 0.0173); (4) marked cellularity (p = 0.0112); (5) presence of ulceration of overlying gastric mucosa (p = 0.0091); (6) tumor size > 5 cm (p = 0.0195); and (7) exogastric growth pattern (p = 0.0344). Tumors with MC > 5/50 HPF and size > 5 cm were found to be strong indicators of an unfavorable prognosis. The type of surgery and tumor site did not affect the prognosis of the patients.
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