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Tumor necrosis is significantly associated with reduced recurrence-free survival after curative resection of gastrointestinal stromal tumors.

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Date
2020-11-10
ICR Author
Smith, Myles
Hayes, Andrew
Author
Tyler, R
Davies, E
Tan, D
Hodson, J
Taniere, P
Thway, K
Jafri, M
Almond, M
Ford, S
Strauss, D
Hayes, A
Smith, M
Desai, A
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Type
Journal Article
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Abstract
Background objectives The impact of tumor necrosis as a prognostic factor in gastrointestinal stromal tumor (GISTs) is still debated. The objective was to determine whether tumor necrosis is an independent risk factor for survival in patients with GISTs.Methods Patients undergoing surgery for primary GIST from March 2003 to October 2018 at two sarcoma referral centers were retrospectively identified. Patients who received neoadjuvant imatinib were excluded. Multivariable Cox regression models were produced, to assess whether tumor necrosis was an independent predictor of either overall or recurrence-free survival.Results Forty-one out of 195 (21.0%) patients had tumor necrosis. Tumor necrosis was associated with a significantly higher modified National Institute of Health risk score, with 29 out of 41 (70.7%) patients with necrosis classified as high risk, compared to 52 out of 153 (34.0%) without (p < .001). Tumor necrosis was found to be independently predictive of recurrence-free survival (hazard ratio: 5.26, 95% CI: 2.62-10.56, p < .001) on multivariable analysis. At 5 years, 44.3% of patients with necrosis had either died or developed recurrence, compared to 9.9% of those without.Conclusion Tumor necrosis is an independent predictor of recurrence-free survival in patients with operable GISTs. It should be routinely reported by pathologists, and used by clinicians when counseling patients and deciding on adjuvant therapy.
URI
https://repository.icr.ac.uk/handle/internal/4239
DOI
https://doi.org/10.1002/jso.26294
Collections
  • Radiotherapy and Imaging
Research team
Sarcoma and Melanoma Surgery
Language
eng
Date accepted
2020-10-30
License start date
2020-11-10
Citation
Journal of surgical oncology, 2020

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