Treatment And Prognosis Of Gastrointestinal Stromal Tumor: An Analysis Of 144 Patients

Objective:To explore the clinical presentations of gastrointestinal stromal tumors and the diagnosis, tumor pathology, neoadjuvant treatment and prognosis of GIST, to improve the diagnostic rate and cure rate of GIST.Methods:The clinicopathological data and followed-up data of the one hundred and forty-four patients with GIST treated at Qilu Hospital of Shandong University from January 2005 to December 2010 were reviewed and the prognosic factors were evaculated.Results:GIST originated respectively from esophago(n=7), stomach(n=89), duodenum(n=6), intestine(n=25)(including those from duodenum), colon(n=4), rectum(n=5), others (n=14).141 cases were resected completely and there was no operative mortality.144 cases were followed-up, and 47 cases had recurrenced and metastisis of which the most common organ to recurrence was liver. The 1-,2-and 3-year survival rates of the 57 cases who had recepted adjuvant therapy with imatinib were 98.2%,96.5%,93.0% respectively. After resisitance of IM,16 patients had recepred sunitinib and the control rate of progressive disease was 56.25%. The 1-,2-and 3-year survival rates of the 87 cases who had not recepted adjuvant therapy with imatinib were 92.8%,80.4%,75.3% respectively. Univariate analysis revealed that the tunor size, complete tumor resection, mitotic count, Flecher classification and adjuvant postoperative therapy with imatinib and sunitinib were related to the survival rates.Conclusion:For GIST, complete surgery resection is the first choice. Flecher classification is effective to evaluate the behaviors and prognosis. The targeted therapy with inatinib and sunitinib can improve survival.