Clinical Analysis Of Factors Influencing The Prognosis Of Gastrointestinal Stromal Tumors

Objection: To analyze the effect of various clinical factors on the prognosis of patients with gastrointestinal stromal tumors(GIST)and determine the possible related factors affecting the prognosis of gastrointestinal stromal tumor and summarize the main points of clinical diagnosis and treatment of gastrointestinal stromal tumors.Methods: 107 cases of GIST patients in Surgery Department of Gastrointestinal Disease of the First Affiliated Hospital of Chongqing Medical University during April 2005 to March 2013 were retrospectively reviewed.The clinical characteristics were analysis,and the tumor progression of patients was followed up after surgery and prognosis was evaluated by the progression free survival.Univariate analysis was used on the standardization of imatinib mesylate therapy,combine with previous clinical experience and select the effective index.related factors were analyzed by Cox model regression analysis.The statistical processing,inspection and analysis of data were handled with the use of SPSS software,the difference in P values less than 0.05 were statistically significant.Result:107 cases of patients were selected in this study,and 3 cases were not included for uncompleted primary disease inspection results.In the total of 104 cases,4 low-risk patients,40 intermediate risk patients,70 high-risk patients were included.The tumor size,mitotic count,primary site,rupture or not,R0 resected immediately or not and standardized imatinib mesylate therapy or not were univariate survival analyzed.And the results showed whether standardizing imatinib mesylate treatment was closely related to the prognosis of GIST(P < 0.001),primary resection(P = 0.01),the primary site(P = 0.01),tumor size(P =0.04),mitotic count(P =0.04)were the factors of affecting the prognosis of gastrointestinal stromal tumor.In univariate analysis,tumor rupture for the prognosis was unclear and the statistical results showed no significant difference(P=0.503).COX multivariate analysis indicated that whether standardizing imatinib treatment was related to the whole prognosis of GIST,and significant difference existed(P<0.001).Selection of standardizing imatinib mesylate therapy can improve the prognosis remarkably(RR=8.04).Tumor size,mitotic count,R0 resected immediately or not,tumor rupture all can affect prognosis and the difference was statistically significant.While difference of different location of the tumor in the multi factor regression analysis was not significant(P),which suggested a possible wide application of imatinib adjuvant therapy led a weak influence of primary tumor site on prognosis of patients need targeted therapy.Conclusion: After the targeted therapy is widely used in clinic,as for the effect on prognosis of GIST,whether standardizing imatinib mesylate treatment is clearly independent risk factor and other factors like tumor size,mitotic count,tumor rupture and primary R0 resection also included.The widespread use of imatinib caused change in whole prognosis of patients and early clinical factors related to the prognosis such as tumor primary site may not accurately reflect the prognosis.For patients with GIST and need targeted therapy,standardize imatinib mesylate treatment can bring significant prognostic improvement.And preliminary diagnosis about whether R0 resected or not is also closely related to prognosis,so for clinicians.early and timely surgical resection and postoperative specification of imatinib therapy are the goals that should be achieved in the process of clinical diagnosis and treatment.