Clinicopathologic Features And Prognostic Impact Of Gastric Gastrointestinal Stromal Tumors Occurring Synchronously With Gastric Cancer

Objective To evaluated the clinicopathologic features and prognostic impact of gastric gastrointestinal stromal tumors occurring synchronously with gastric cancer. Methods The clinicopathologic date of 122 patients with gastric gastrointestinal stromal tumors who underwent surgical treatment from January 2000 to December 2010 were analyzed retrospectively.Twenty-six patients presented with gastric cancer con- currence(combined group),while 96 patients did not ( no-combined group).The clinicopathologic features of gastric GIST in combined group were studied.The 5-year survival rates were compared between two groups and between patients with different Fletcher classification in the combined group.Potential patient prognostic factors were evaluated by univariate and multivariate analyses.The independent prognostic factors of patients were performed subgroup analysis.Results Gastric GIST with small tumor diameter,little mitotic count or very low-/low-risk of aggressive behavior were significantly more common in the combined group than that in the no-combined group,respectively with significantly difference (P<0.05).The 5-year survival rate was 55.3% for patients with gastric cancer concurrence and 79.4% for patients without,the difference was statistically significantly between the two group (P<0.05).On univariate analysis, maximum tumor diameter,mitotic count,Fletcher classification and whether or not coexist with gastric cancer were the independent predictive factors of survival.The Fletcher classification and whether or not coexist with gastric cancer were the independent prognostic factors.In the subgroup analysis,the 5-year survival rates of very low-/low-risk,intermediate-risk or high-risk gastric stromal tumors which coexsitd with gastric cancer were all lower than that of gastric stomal tumors alone,respectively with significantly difference(P<0.05).Conclusions In the patients of synchronous incidental gastric GIST and gastric cancer,the Fletcher classification of gastrointestinal stromal tumors were mostly very low or low invasion risk;The prognosis of these patients is poor, the treatment should be based on the gastric cancer primarily.