Comparing the long-term outcomes among patients with stomach and small intestine gastrointestinal stromal tumors: An analysis of the National Cancer Database

Katherine Giuliano, Aslam Ejaz, Bradley N. Reames, Won Seok Choi, Jonathan Sham, Michele Gage, Fabian M. Johnston, Nita Ahuja

Research output: Contribution to journalArticle

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Abstract

Background and Objectives: Gastrointestinal stromal tumors (GIST) are the most common sarcoma arising from the gastrointestinal tract. Data regrading long-term prognosis based on tumor location (stomach vs small intestine) are mixed, so we aimed to analyze their outcomes using a large national oncology database. Methods: The National Cancer Database was queried for cases of stomach and small intestine GIST between the years 2004 and 2014. Survival analysis was performed using the Kaplan-Meier method, and factors related to survival were compared using the Cox proportional hazards model. Results: Of 18 900 total patients, those with small intestine GIST had larger median tumor size (6.2 cm; interquartile range [IQR], 3.8 to 10.0 vs stomach: 5.0 cm; IQR, 3.0 to 9.0; P < 0.001) and a higher incidence of tumors with ≥5 mitoses/50 HPF (29.3% vs stomach: 24.2%; P < 0.001). Unadjusted median overall survival (OS) was longer for patients with stomach GIST (10.3 years) as compared to small intestine GIST (9.4 years) (P = 0.01). After controlling for patient and tumor-related factors, however, OS did not differ between stomach and small intestine GIST (hazard ratio, 1.19; 95% confidence interval, 0.88 to 1.61; P = 0.26). Conclusions: Patients with small intestine GIST more commonly have larger, high mitotic rate tumors, but despite these worse prognostic features, tumor location did not independently impact OS.

Original languageEnglish (US)
Pages (from-to)486-492
Number of pages7
JournalJournal of Surgical Oncology
Volume118
Issue number3
DOIs
StatePublished - Sep 1 2018

Fingerprint

Gastrointestinal Stromal Tumors
Small Intestine
Stomach
Databases
Neoplasms
Survival
Survival Analysis
Proportional Hazards Models
Mitosis
Sarcoma
Gastrointestinal Tract
Confidence Intervals
Incidence

Keywords

  • GIST
  • National Cancer Database
  • gastrointestinal stromal tumors
  • small intestine GIST
  • stomach GIST

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Comparing the long-term outcomes among patients with stomach and small intestine gastrointestinal stromal tumors : An analysis of the National Cancer Database. / Giuliano, Katherine; Ejaz, Aslam; Reames, Bradley N.; Choi, Won Seok; Sham, Jonathan; Gage, Michele; Johnston, Fabian M.; Ahuja, Nita.

In: Journal of Surgical Oncology, Vol. 118, No. 3, 01.09.2018, p. 486-492.

Research output: Contribution to journalArticle

Giuliano, Katherine ; Ejaz, Aslam ; Reames, Bradley N. ; Choi, Won Seok ; Sham, Jonathan ; Gage, Michele ; Johnston, Fabian M. ; Ahuja, Nita. / Comparing the long-term outcomes among patients with stomach and small intestine gastrointestinal stromal tumors : An analysis of the National Cancer Database. In: Journal of Surgical Oncology. 2018 ; Vol. 118, No. 3. pp. 486-492.
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abstract = "Background and Objectives: Gastrointestinal stromal tumors (GIST) are the most common sarcoma arising from the gastrointestinal tract. Data regrading long-term prognosis based on tumor location (stomach vs small intestine) are mixed, so we aimed to analyze their outcomes using a large national oncology database. Methods: The National Cancer Database was queried for cases of stomach and small intestine GIST between the years 2004 and 2014. Survival analysis was performed using the Kaplan-Meier method, and factors related to survival were compared using the Cox proportional hazards model. Results: Of 18 900 total patients, those with small intestine GIST had larger median tumor size (6.2 cm; interquartile range [IQR], 3.8 to 10.0 vs stomach: 5.0 cm; IQR, 3.0 to 9.0; P < 0.001) and a higher incidence of tumors with ≥5 mitoses/50 HPF (29.3{\%} vs stomach: 24.2{\%}; P < 0.001). Unadjusted median overall survival (OS) was longer for patients with stomach GIST (10.3 years) as compared to small intestine GIST (9.4 years) (P = 0.01). After controlling for patient and tumor-related factors, however, OS did not differ between stomach and small intestine GIST (hazard ratio, 1.19; 95{\%} confidence interval, 0.88 to 1.61; P = 0.26). Conclusions: Patients with small intestine GIST more commonly have larger, high mitotic rate tumors, but despite these worse prognostic features, tumor location did not independently impact OS.",
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