Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The clinicopathological features and outcome of gastrointestinal stromal tumors (GISTs) with lymph node metastasis remain controversial owing to their low incidence. A multicenter retrospective cohort study was conducted to compare the clinicopathological features and oncologic outcomes of GIST without metastasis, with lymph node metastasis, and with distant metastasis. DESIGN: The medical records of patients with GISTs in 16 large medical centers in China from January 2014 to December 2022 were reviewed. Patients were divided into four groups: no metastasis (988 cases, 89.1%), lymph node metastasis without distant metastasis (75 cases, 6.8%), distant metastasis without lymph node metastasis (36 cases, 3.2%), and distant metastasis with lymph node metastasis group (10 cases, 0.9%). Propensity score matching (PSM) was performed to reduce confounding factors. RESULT: A total of 1109 cases of primary GIST were included in this study, comprising 607 males (54.7%) and 502 females (45.3%), with a mean age of 56.6 ± 11.9 years. Compared to that in GIST without lymph node metastasis, the proportion of nongastric GIST was higher in GIST with lymph node metastasis (52.9% vs 40.7%) with a larger tumor diameter (>10 cm: 36.5% vs 18.1%) and more patients with distant metastasis (11.8% vs 3.5%). Tumor location not in the stomach, the largest tumor diameter, and distant metastasis were independent risk factors for GIST with lymph node metastasis (all P < .05). After PSM, 96, 48, 24 patients comprised no metastasis, lymph node metastasis without distant metastasis, and distant metastasis without lymph node metastasis, respectively. The relapse-free survival (RFS) of the lymph node metastasis group was comparable to that of the distant metastasis group without lymph node metastasis (P = .368) and significantly inferior to that of no metastases (P = .042). CONCLUSIONS AND RELEVANCE: The RFS of patients with GIST with lymph node metastasis was comparable to those with distant metastasis and significantly worse than those without metastasis. Lymph node metastasis is an advanced event in GIST.
Source: The Oncologist
Authors: Qi Jiang, Peng Zhang, Weili Yang, Xiaodong Gao, Yingfeng Fu, Jun Zhang, Bo Zhang, Fan Feng, Gang Zhai, Yang Fu, Xin Wu, Xinhua Zhang, Xiaojun Wu, Zhidong Gao, Han Liang, Yanbing Zhou, Heli Liu, Kaixiong Tao
Institutions: Wuhan Union Hospital, Huazhong University of Science and Technology, First Affiliated Hospital Zhejiang University, Zhejiang University, Shanghai Medical College of Fudan University, Fudan University, Zhongshan Hospital, Hubei University of Medicine, Taihe Hospital, First Affiliated Hospital of Zhengzhou University, The Affiliated Yongchuan Hospital of Chongqing Medical University, Sichuan University, West China Medical Center of Sichuan University, West China Hospital of Sichuan University, Xijing Hospital, Air Force Medical University, Shanxi Provincial Cancer Hospital, Chinese PLA General Hospital, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, The First Affiliated Hospital, Sun Yat-sen University, Peking University, Peking University People's Hospital, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Affiliated Hospital of Qingdao University, Central South University, Xiangya Hospital Central South University
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,852
Awards: G4094896397, G6780249917, G7770603838
OpenAlex ID: W4415283122