| Title | Clinicopathological Outcomes and Prognosis of Elderly Patients (65Years) with Gastric Gastrointestinal Stromal Tumors (GISTs) Undergoing Curative-Intent Resection: a Multicenter Data Review |
| Authors | Yang, Zifeng Feng, Xingyu Zhang, Peng Chen, Tao Qiu, Haibo Zhou, Yongjian Du, Chunyan Yin, Xiaonan Pan, Fang Zheng, Guoliang Liu, Xiufeng Huang, Changming Zhou, Zhiwei Li, Guoxin Tao, Kaixiong Li, Yong |
| Affiliation | Guangdong Acad Med Sci, Guangdong Gen Hosp, Dept Gen Surg, Guangzhou 510080, Guangdong, Peoples R China Huazhong Univ Sci & Technol, Dept Gen Surg, Union Hosp, Tongji Med Coll, Wuhan 430030, Hubei, Peoples R China Southern Med Univ, Nanfang Hosp, Dept Gen Surg, Guangzhou 510515, Guangdong, Peoples R China Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, Dept Gastr & Pancreat Surg,State Key Lab Oncol So, Guangzhou 510060, Guangdong, Peoples R China Fujian Med Univ, Dept Gastr Surg, Union Hosp, Fuzhou 350001, Fujian, Peoples R China Fudan Univ, Dept Gastr & Soft Tissue Surg, Shanghai Canc Ctr, Shanghai 200032, Peoples R China Sichuan Univ, West China Hosp, Dept Gastrointestinal Surg, Chengdu 610041, Sichuan, Peoples R China Peking Univ, Dept Gastrointestinal Oncol, Canc Hosp & Inst, Beijing 100142, Peoples R China China Med Univ, Liaoning Canc Hosp & Inst, Dept Canc Hosp, Shenyang 110042, Liaoning, Peoples R China 81st Hosp PLA, Peoples Liberat Army PLA Canc Ctr, Dept Oncol, Nanjing 210000, Jiangsu, Peoples R China |
| Keywords | Clinicopathological outcomes Prognosis Gastric GIST Elderly patients |
| Issue Date | 2019 |
| Publisher | JOURNAL OF GASTROINTESTINAL SURGERY |
| Abstract | BackgroundThe most common site of gastrointestinal stromal tumors (GISTs) is the stomach, and gastric GISTs (gGISTs) occur most often in elderly patients. However, the clinicopathological features, treatment patterns, and prognosis of elderly patients with gGISTs remain unclear.MethodsWe retrospectively collected clinicopathological and prognostic data for patients with primary gGISTs who underwent curative-intent resection at 10 medical centers in China from 1998 to 2015.ResultsOver the 18years, 10 medical centers treated 1846 patients with primary gGISTs by curative-intent resection. The median age was 59 (range 18-91)years. The patients were classified into two groups according to age, namely an elderly group (65years of age) and a nonelderly group (<65years of age). The elderly group had more comorbidities (40.7% vs 23.5%, p=0.011), a higher rate of postoperative complications (14.4% vs 8.7%, p=0.031), and a lower proportion of intermediate/high-risk patients who received adjuvant therapy (30.0% vs 66.8%, p=0.001) than did the nonelderly group. Regarding pathological outcomes, a significant difference in tumor necrosis was observed between the two groups (p=0.002), and more cases of tumor necrosis occurred in the elderly group than in the nonelderly group. Regarding postoperative recovery outcomes, no significant difference was observed between the two groups. Univariate analysis showed that age, postoperative complications, adjuvant therapy, tumor size, mitotic count, modified National Institutes of Health (NIH) risk category, and tumor necrosis were factors that affected disease-free survival (DFS). Multivariate analysis showed that modified NIH risk category was the only independent factor affecting DFS. The 5-year DFS rates in the nonelderly and elderly groups were 88.1% and 81.4%, respectively (p=0.034), and the 5-year overall survival (OS) rates were 90.4% and 85.5% (p=0.038), respectively.ConclusionsCurrently, the treatment patterns for elderly patients with gGISTs remain the same as those for young patients with gGISTs. Elderly gGIST patients had more comorbidities and postoperative complications than did nonelderly gGIST patients, and fewer elderly gGIST patients received postoperative adjuvant therapy. Elderly gGIST patients also had a higher rate of tumor necrosis and worse DFS and OS than did young gGIST patients. Further exploration into the diagnosis and treatment patterns of elderly patients is therefore essential. |
| URI | http://hdl.handle.net/20.500.11897/548835 |
| ISSN | 1091-255X |
| DOI | 10.1007/s11605-018-3944-1 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 |
