Tumor necrosis and >20 mitoses per 50 high-power fields can distinguish 'very high-risk' and 'highest-risk' within 'high-risk' gastric gastrointestinal stromal tumor

Future Oncol. 2018 Mar;14(7):621-629. doi: 10.2217/fon-2017-0509. Epub 2018 Feb 7.

Abstract

Aim: We aimed to investigate the optimal criteria for classifying higher risk forms of gastric gastrointestinal stromal tumor (gGIST).

Materials & methods: A total of 246 high-risk gGIST patients were enrolled. Univariate and multivariate analyses were conducted to determine the association between clinicopathological features and overall survival. Appropriate cut-off values were calculated to identify those at higher risk of gGIST.

Results: Multivariate and univariate analyses revealed that tumor necrosis and mitotic counts are independent risk factors for overall survival. The optimal cut-off value of mitotic counts was 20. Patients with both necrosis and >20 mitoses/50 high-power fields were worse than those with either one.

Conclusion: Tumor necrosis and >20 mitoses/50 high-power fields are independent risk factors for high-risk gGIST. Patients with both risk factors indicate worse prognosis.

Keywords: cut-off value; gastric GIST; high risk; mitotic counts; tumor necrosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Gastrointestinal Stromal Tumors / diagnosis
  • Gastrointestinal Stromal Tumors / genetics*
  • Gastrointestinal Stromal Tumors / pathology
  • Humans
  • Male
  • Middle Aged
  • Mitosis / genetics*
  • Multivariate Analysis
  • Necrosis / diagnosis
  • Necrosis / genetics*
  • Necrosis / pathology
  • Prognosis
  • Risk Factors