Original Article
Suggested cutoff tumor size for small gastric gastrointestinal stromal tumors
Abstract
Background: To investigate if there is an appropriate cutoff tumor size for small gastric gastrointestinal stromal tumors (GISTs) or not, and whether the cutoff size could be used to predict the tumor progression for small gastric GISTs during follow-up.
Methods: From May 2010 to March 2014, 97 patients were enrolled in the present study, including 90 small gastric GIST patients underwent resection, and 7 endoscopic ultrasound (EUS) suspected small gastric GIST patients. The cutoff tumor size of small gastric GISTs was calculated based on mitotic index using receiver operating characteristic (ROC) analysis.
Results: Of the 90 patients, mitotic index of 18 small gastric GISTs (20%) exceeded 5/50 HPF. Using ROC analysis, we found that 1.4 cm may be considered as an appropriate cutoff tumor size. The ratio of CT enhancement, tumor ulceration, mitotic index exceeds 5/50 HPF and low risk category was significantly higher in tumors between 1.4 and 2.0 cm than that of tumors less than 1.4 cm (all P<0.05). EUS suspected small gastric GISTs between 1.4 and 2.0 cm showed significant tumor progression during follow-up (median 11.8 months, range from 10.1 to 24.5 months).
Conclusions: The 1.4-cm may be considered as a more reasonable cutoff tumor size for small gastric GISTs. We recommended that all small gastric GISTs should be resected once diagnosed, at least for tumors between 1.4 and 2.0 cm.
Methods: From May 2010 to March 2014, 97 patients were enrolled in the present study, including 90 small gastric GIST patients underwent resection, and 7 endoscopic ultrasound (EUS) suspected small gastric GIST patients. The cutoff tumor size of small gastric GISTs was calculated based on mitotic index using receiver operating characteristic (ROC) analysis.
Results: Of the 90 patients, mitotic index of 18 small gastric GISTs (20%) exceeded 5/50 HPF. Using ROC analysis, we found that 1.4 cm may be considered as an appropriate cutoff tumor size. The ratio of CT enhancement, tumor ulceration, mitotic index exceeds 5/50 HPF and low risk category was significantly higher in tumors between 1.4 and 2.0 cm than that of tumors less than 1.4 cm (all P<0.05). EUS suspected small gastric GISTs between 1.4 and 2.0 cm showed significant tumor progression during follow-up (median 11.8 months, range from 10.1 to 24.5 months).
Conclusions: The 1.4-cm may be considered as a more reasonable cutoff tumor size for small gastric GISTs. We recommended that all small gastric GISTs should be resected once diagnosed, at least for tumors between 1.4 and 2.0 cm.
