The Analysis On Clinical Characteristics Of Gastrointestinal Stromal Tumors(GISTs) Patients With Gastrointestinal Bleeding

Objective:Though the impact of gastrointestinal(GI)bleeding on the prognosis of Gastrointestinal Stromal Tumor(GIST)patients has been reported by several studies,the conclusion of this matter still remains inconsistent.This research aimed to investigate the clinical features and prognosis of the GIST patients with gastrointestinal bleeding.Methods:The retrospective analysis was conducted on the patients who underwent GIST resection between January 2000 and December 2008.All patients did not receive postoperative targeted therapy.After carefully reviewing their medical records,the GI bleeding was certainly caused by the GIST.Results:A total of 125 GIST patients with GI bleeding were included in this study.There were 72 males and 53 females.The median age was 57 years(range:19-89 years).The tumor was mostly located on the small intestine(56 cases),followed by stomach(40 cases),duodenum(21 cases),and colorectum(8 cases).The median tumor size was 5.0 cm(range:2.1-10.0 cm)and median mitotic count was 2(range:0-200)/50 High Power Fields(HPF).On the comparison with 117 non-GI bleeding GIST patients,GI bleeding was more frequently found in small intestinal GIST patients.Furthermore,the smaller the tumor size was,the higher the proportion of GI bleeding.The median follow-up of total patients was 120 months(range:10-215 months).Univariate and multivariate analysis showed that GI bleeding was not the independent prognostic factor for postoperative tumor recurrence(p>0.05).For patients with tumor size smaller than 5.0 cm,patients with GI bleeding suffered poorer prognosis compared with those without GI bleeding(p=0.039).For low-risk GIST patients,the tumor recurrence also seemed higher in GI bleeding patients when compared with those without GI bleeding(p=0.06).Conclusion:The proportion of GI bleeding was higher in small intestinal GIST patients.For the patients with tumor size smaller than 5.0 cm or low-risk GIST,the risk of tumor recurrence was relatively higher on the patients with GI bleeding.However,further research is still needed to determine the necessity of postoperative targeted therapy.