Tumor necrosis is significantly associated with reduced recurrence-free survival after curative resection of gastrointestinal stromal tumors.
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Embargo End Date
ICR Authors
Authors
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
Davies, E
Tan, D
Hodson, J
Taniere, P
Thway, K
Jafri, M
Almond, M
Ford, S
Strauss, D
Hayes, A
Smith, M
Desai, A
Document Type
Journal Article
Date
2020-11-10
Date Accepted
2020-10-30
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.
Citation
Journal of surgical oncology, 2020
Source Title
Publisher
WILEY
ISSN
0022-4790
eISSN
1096-9098
Collections
Research Team
Sarcoma and Melanoma Surgery