Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less

Mi Young Kim, Young Su Park, Kee Don Choi, Jeong Hoon Lee, Kwi Sook Choi, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon Yong Jung, Jin Ho Kim, Sung Cheol Yun, Kab Choong Kim, Jeong Hwan Yook, Sung Tae Oh, Byung Sik Kim, Min Hee Ryu, Yoon Koo Kang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Goals: To evaluate the recurrence predicting factors of small gastric gastrointestinal stromal tumors (GISTs) through the long-term follow-up after surgical/endoscopic resection. Background: Although small gastric GISTs are known to have a low risk of recurrence after complete resection, the prognostic factors are not well known. Study: The study retrospectively analyzed the records of 136 patients with primary gastric GISTs of 5 cm or less without metastasis who underwent surgical/endoscopic resection between March 1997 and December 2008 at the Asan Medical Center, and who were followed-up for at least 3 months after resection. Specimens were assessed for tumor size, mitotic index, and microscopic resection margin. Specimen sections were immunohistochemically stained to determine the levels of expression of the cell cycle proteins p53, p16, pRb, cyclin D1, and Ki-67. DNA was extracted from high-risk tumors to analyze for KIT mutations. Results: Among 136 patients, 5 (3.7%) patients with tumors with a high mitotic index showed recurrence at a median 23 months post resection. None of 14 patients with microscopic positive resection margins showed recurrence during a median follow-up time of 32 months. A high mitotic index was a predictor of recurrence (P<0.001), but that tumor size, method of resection, or margin status were not. In addition, abnormal p53 expression was found to be associated with recurrence (P=0.004). All assessable high-risk tumors had a KIT exon 11 mutation. Conclusions: Predictors of recurrence of gastric GISTs of 5 cm or less were a high mitotic index and abnormal p53 expression. A positive microscopic resection margin was not associated with recurrence.

Original languageEnglish
Pages (from-to)130-137
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume46
Issue number2
DOIs
StatePublished - 1 Feb 2012

Fingerprint

Gastrointestinal Stromal Tumors
Stomach
Recurrence
Mitotic Index
Neoplasms
Cell Cycle Proteins
Mutation
Cyclin D1
Exons
Neoplasm Metastasis
Margins of Excision
DNA

Keywords

  • gastrointestinal stromal tumors
  • mitotic index
  • p53
  • prognosis
  • stomach

Cite this

Kim, Mi Young ; Park, Young Su ; Choi, Kee Don ; Lee, Jeong Hoon ; Choi, Kwi Sook ; Kim, Do Hoon ; Song, Ho June ; Lee, Gin Hyug ; Jung, Hwoon Yong ; Kim, Jin Ho ; Yun, Sung Cheol ; Kim, Kab Choong ; Yook, Jeong Hwan ; Oh, Sung Tae ; Kim, Byung Sik ; Ryu, Min Hee ; Kang, Yoon Koo. / Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less. In: Journal of Clinical Gastroenterology. 2012 ; Vol. 46, No. 2. pp. 130-137.
@article{dd8b82616b394b7b866dade5e31d02f0,
title = "Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less",
abstract = "Goals: To evaluate the recurrence predicting factors of small gastric gastrointestinal stromal tumors (GISTs) through the long-term follow-up after surgical/endoscopic resection. Background: Although small gastric GISTs are known to have a low risk of recurrence after complete resection, the prognostic factors are not well known. Study: The study retrospectively analyzed the records of 136 patients with primary gastric GISTs of 5 cm or less without metastasis who underwent surgical/endoscopic resection between March 1997 and December 2008 at the Asan Medical Center, and who were followed-up for at least 3 months after resection. Specimens were assessed for tumor size, mitotic index, and microscopic resection margin. Specimen sections were immunohistochemically stained to determine the levels of expression of the cell cycle proteins p53, p16, pRb, cyclin D1, and Ki-67. DNA was extracted from high-risk tumors to analyze for KIT mutations. Results: Among 136 patients, 5 (3.7{\%}) patients with tumors with a high mitotic index showed recurrence at a median 23 months post resection. None of 14 patients with microscopic positive resection margins showed recurrence during a median follow-up time of 32 months. A high mitotic index was a predictor of recurrence (P<0.001), but that tumor size, method of resection, or margin status were not. In addition, abnormal p53 expression was found to be associated with recurrence (P=0.004). All assessable high-risk tumors had a KIT exon 11 mutation. Conclusions: Predictors of recurrence of gastric GISTs of 5 cm or less were a high mitotic index and abnormal p53 expression. A positive microscopic resection margin was not associated with recurrence.",
keywords = "gastrointestinal stromal tumors, mitotic index, p53, prognosis, stomach",
author = "Kim, {Mi Young} and Park, {Young Su} and Choi, {Kee Don} and Lee, {Jeong Hoon} and Choi, {Kwi Sook} and Kim, {Do Hoon} and Song, {Ho June} and Lee, {Gin Hyug} and Jung, {Hwoon Yong} and Kim, {Jin Ho} and Yun, {Sung Cheol} and Kim, {Kab Choong} and Yook, {Jeong Hwan} and Oh, {Sung Tae} and Kim, {Byung Sik} and Ryu, {Min Hee} and Kang, {Yoon Koo}",
year = "2012",
month = "2",
day = "1",
doi = "10.1097/MCG.0b013e31821f8bf6",
language = "English",
volume = "46",
pages = "130--137",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins Ltd.",
number = "2",

}

Kim, MY, Park, YS, Choi, KD, Lee, JH, Choi, KS, Kim, DH, Song, HJ, Lee, GH, Jung, HY, Kim, JH, Yun, SC, Kim, KC, Yook, JH, Oh, ST, Kim, BS, Ryu, MH & Kang, YK 2012, 'Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less', Journal of Clinical Gastroenterology, vol. 46, no. 2, pp. 130-137. https://doi.org/10.1097/MCG.0b013e31821f8bf6

Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less. / Kim, Mi Young; Park, Young Su; Choi, Kee Don; Lee, Jeong Hoon; Choi, Kwi Sook; Kim, Do Hoon; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon Yong; Kim, Jin Ho; Yun, Sung Cheol; Kim, Kab Choong; Yook, Jeong Hwan; Oh, Sung Tae; Kim, Byung Sik; Ryu, Min Hee; Kang, Yoon Koo.

In: Journal of Clinical Gastroenterology, Vol. 46, No. 2, 01.02.2012, p. 130-137.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of recurrence after resection of small gastric gastrointestinal stromal tumors of 5 cm or less

AU - Kim, Mi Young

AU - Park, Young Su

AU - Choi, Kee Don

AU - Lee, Jeong Hoon

AU - Choi, Kwi Sook

AU - Kim, Do Hoon

AU - Song, Ho June

AU - Lee, Gin Hyug

AU - Jung, Hwoon Yong

AU - Kim, Jin Ho

AU - Yun, Sung Cheol

AU - Kim, Kab Choong

AU - Yook, Jeong Hwan

AU - Oh, Sung Tae

AU - Kim, Byung Sik

AU - Ryu, Min Hee

AU - Kang, Yoon Koo

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Goals: To evaluate the recurrence predicting factors of small gastric gastrointestinal stromal tumors (GISTs) through the long-term follow-up after surgical/endoscopic resection. Background: Although small gastric GISTs are known to have a low risk of recurrence after complete resection, the prognostic factors are not well known. Study: The study retrospectively analyzed the records of 136 patients with primary gastric GISTs of 5 cm or less without metastasis who underwent surgical/endoscopic resection between March 1997 and December 2008 at the Asan Medical Center, and who were followed-up for at least 3 months after resection. Specimens were assessed for tumor size, mitotic index, and microscopic resection margin. Specimen sections were immunohistochemically stained to determine the levels of expression of the cell cycle proteins p53, p16, pRb, cyclin D1, and Ki-67. DNA was extracted from high-risk tumors to analyze for KIT mutations. Results: Among 136 patients, 5 (3.7%) patients with tumors with a high mitotic index showed recurrence at a median 23 months post resection. None of 14 patients with microscopic positive resection margins showed recurrence during a median follow-up time of 32 months. A high mitotic index was a predictor of recurrence (P<0.001), but that tumor size, method of resection, or margin status were not. In addition, abnormal p53 expression was found to be associated with recurrence (P=0.004). All assessable high-risk tumors had a KIT exon 11 mutation. Conclusions: Predictors of recurrence of gastric GISTs of 5 cm or less were a high mitotic index and abnormal p53 expression. A positive microscopic resection margin was not associated with recurrence.

AB - Goals: To evaluate the recurrence predicting factors of small gastric gastrointestinal stromal tumors (GISTs) through the long-term follow-up after surgical/endoscopic resection. Background: Although small gastric GISTs are known to have a low risk of recurrence after complete resection, the prognostic factors are not well known. Study: The study retrospectively analyzed the records of 136 patients with primary gastric GISTs of 5 cm or less without metastasis who underwent surgical/endoscopic resection between March 1997 and December 2008 at the Asan Medical Center, and who were followed-up for at least 3 months after resection. Specimens were assessed for tumor size, mitotic index, and microscopic resection margin. Specimen sections were immunohistochemically stained to determine the levels of expression of the cell cycle proteins p53, p16, pRb, cyclin D1, and Ki-67. DNA was extracted from high-risk tumors to analyze for KIT mutations. Results: Among 136 patients, 5 (3.7%) patients with tumors with a high mitotic index showed recurrence at a median 23 months post resection. None of 14 patients with microscopic positive resection margins showed recurrence during a median follow-up time of 32 months. A high mitotic index was a predictor of recurrence (P<0.001), but that tumor size, method of resection, or margin status were not. In addition, abnormal p53 expression was found to be associated with recurrence (P=0.004). All assessable high-risk tumors had a KIT exon 11 mutation. Conclusions: Predictors of recurrence of gastric GISTs of 5 cm or less were a high mitotic index and abnormal p53 expression. A positive microscopic resection margin was not associated with recurrence.

KW - gastrointestinal stromal tumors

KW - mitotic index

KW - p53

KW - prognosis

KW - stomach

UR - http://www.scopus.com/inward/record.url?scp=84855791811&partnerID=8YFLogxK

U2 - 10.1097/MCG.0b013e31821f8bf6

DO - 10.1097/MCG.0b013e31821f8bf6

M3 - Article

C2 - 21617541

AN - SCOPUS:84855791811

VL - 46

SP - 130

EP - 137

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 2

ER -