Clinicopathologic Feature And Analysis Of Diagnosis And Treatment Of 115 Cases Of Gastrointestinal Stromal Tumor(GIST)

Objective: To investigate the clinicopathologic features,surgical methods,postoperative adjuvant treatment with imatinib mesylate(IM)and its influencing factors in gastrointestinal stromal tumors(GIST).Methods: The clinical data of 115 primary GIST patients admitted to handan central hospital from March 2015 to October 2018 who met the inclusion criteria was analyzed retrospectively.Compared the effects of clinicopathologic features,surgical methods and IM on patient’s survival.The SPSS21.0 was used for relevant statistical treatment.The number of cases and percentage % represented the enumeration data and the test method was chi-square.T test was used for measurement data.Single factor survival analysis used Kaplan-Meier to caculating survival rate and log-rank was used to testing whether it is significant or not.Multifactorial survival analysis uesd COX regression model.P<0.05 represented that the difference was statistically sinificant.Results: All patients received surgical treatment.Traditional open abdominal resection was performed in 64 cases,and laparoscopic resection was performed in 51 cases.There was 50 middle or high risk patients who received imatinib adjuvant therapy.Patients were graded for biological risk according to the modifided NIH criteria-proposed by the National Institutes of Health(NIH)-that there were 10 patients with very low risk,27 patients with low risk,12 patients with moderate risk and 66 patients with high risk.The overall survival rate of the whole group of 1-year after the surgery was 90%,2-year was 88%,and 3-year was 74%.The survival rates of 1-year,2-year,3-year were all 100% in patients with samll tumors(d<=2cm).The results of single factor survival analysis showed that the lacation of the tumor,the size of the tumer,mitotic figure,the modifided NIH criteria,tumor rupture,comlete resection of tumor(R0 resection)and postoperative imatinib adjuvant therapy had a significant effect on the prognosis of GIST patients(P<0.05),while surgical methods had no effect(P<0.05).The results of multifactorial survival analysis showed that tumor rupture,comlete resection of tumor(R0 resection)and postoperative imatinib adjuvant therapy were independent risk factors for the prognosis of GIST patients(P<0.05).Conclusions:1.Surgical methods have no significant effect on survival rate of GIST patients.2.The lacation of the tumor,the size of the tumer,mitotic figure,the modifided NIH criteria,whether the tumor ruptured or not,whether comletely resected the tumor(R0 resection)or not,and whether received postoperative imatinib adjuvant therapy have a great influence on survival rate of GIST patients,and the prognosis of patients could be very poor if the tumor ruptured,the tumor was not completely removed or postoperative routine oral adjuvant therapy with imatinib was not performed.3.GIST patients with middle or high risk must performe postoperative routine oral adjuvant therapy with imatinib.4.Laparoscopic resection of the tumor should be preferred if GIST tumors are easy to removed and there is good technique of laparoscopic surgery.5.Eariy detection of samll-sized GIST tumors and surgical treatment may prevent patients from recurrence for life.