Analysis Of Death-related Factors In Patients With Gastrointestinal Stromal Tumors

Objective: Analyze the clinical characteristics and treatment of patients with gastrointestinal stromal tumors,and investigate the related factors of death.Methods: The clinical data of patients with gastrointestinal stromal tumors diagnosed and treated between January 2007 and January 2017 of the First Affiliated Hospital of Chongqing Medical University were retrospectively collected,and taking death as the end event,the factors such as the gender,age,tumor location,histopathology and gene mutations,treatment information(surgery and drugs),Therapeutic drug monitoring,and medication status of the patients were analyzed,and related factors affecting their survival prognosis were obtained.Results: IN the tumors of the 280 patients,134 cases(47.9%)located in stomach,15 cases(5.4%)in duodenum,90 cases(32.1%)in small intestine,21 cases(7.5%)in colorectal,and 20 cases(7.1%)in other sites.183 cases(65.4%)were treated with postoperative adjuvant therapy,25cases(8.9%)were treated with neoadjuvant therapy,52 cases(18.2%)weretreated with surgery alone,21 cases(7.5%)were treated with drugs alone.In the surgical treatment of 259 patients(including neoadjuvant therapy),99 cases(38.2%)were recurrence or metastasis.And in the 21 patients with medical treatment alone,10 cases(47.6%)were progress,11 cases(52.4%)were stability.During the follow-up period,51 patients died.And the 3-years OS of all the patients was 96.1%,the 5-years OS was 87.5%,the 10-years OS was 59.7%.the 3-years OS of the patients treated with surgery and medication was 98.1%,the 5-years OS was 94.1%,the10-years OS was 78.0%.Single factor analysis showed that there were significant differences in age(in overall patients),tumor size,mitotic figures,metastasis,postoperative recurrence and metastasis,the choice of operation,resection margin,the drug concentration monitoring,and medication compliance(P <0.05).Multivariate analysis showed that age,mitotic figures,postoperative recurrence or metastasis,and the drug concentration monitoring were independent factors affecting their survival.Conclusion: For patients with GIST,their age,mitotic figures,postoperative recurrence or metastasis are the main risk factors of death,while the drug concentration monitoring is their protective factor.