Background: The risk of recurrence in localised, primary gastrointestinal stromal tumour (GIST) classified as high-risk after complete resection varies significantly. Thus, we aimed to develop a nomogram to predict the recurrence of high-risk GIST after surgery to aid patient selection.
Methods: We retrospectively evaluated patients (n = 424) with high-risk GIST who underwent curative resection as the initial treatment at two high-volume medical centres, between January 2005 and September 2019. The least absolute shrinkage and selection operator (LASSO) regression model was utilised to select potentially relevant features. Multivariate Cox proportional hazards analysis was used to develop a novel nomogram.
Findings: The nomogram comprised age, fibrinogen levels, prognostic nutritional index (PNI), platelet-lymphocyte ratio (PLR), mitotic counts and tumour size, which provided favourable calibration and discrimination in the training dataset with an AUC of 0•749 and a C-index of 0•742 (95%CI:0•689-0•804). Further, it showed acceptable discrimination in the validation cohort, with an AUC of 0•778 and C-index of 0•735 (95%CI:0•634-0•846). The time-dependant receiver operating characteristic (ROC) curves performed well throughout the observation period. Additionally, the nomogram could classify high-risk GISTs into 'very high-risk' and 'general high-risk' groups with a hazard ratio (HR) of 5•190 (95%CI: 3•202-8•414) and 5•438 (95%CI: 2•236-13•229) for the training and validation datasets, respectively.
Interpretation: The nomogram independently predicted post-operative recurrence-free survival (RFS) in high-risk GIST and showed favourable discrimination and calibration values. It may be a useful clinical tool for identifying 'very high-risk' GIST, by allowing treatment strategy optimisation in these patients.
Funding: National Natural Science Foundation of China (No. 81702386 and 81874184).
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522759 | PMC |
| http://dx.doi.org/10.1016/j.ebiom.2020.103016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Low-dose Imatinib Efficacy in a Gastrointestinal Stromal Tumor Patient With Exon 11 W557_K558 Deletion.
In Vivo
December 2024
Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan.
Background/aim: Gastrointestinal stromal tumors (GISTs) are rare cancers originating from Cajal's stromal cells in the gastrointestinal tract. The most common driver mutation in these cancers is the KIT mutation. This report presents a case of response to low-dose imatinib in a patient with GIST harboring KIT exon 11 W557_K558 deletion.
View Article and Find Full Text PDFDeep learning model combined with computed tomography features to preoperatively predicting the risk stratification of gastrointestinal stromal tumors.
World J Gastrointest Oncol
December 2024
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Tianjin 300060, China.
Background: Gastrointestinal stromal tumors (GIST) are prevalent neoplasm originating from the gastrointestinal mesenchyme. Approximately 50% of GIST patients experience tumor recurrence within 5 years. Thus, there is a pressing need to accurately evaluate risk stratification preoperatively.
View Article and Find Full Text PDFImpact of Gastrointestinal Bleeding on Prognosis and Associated Risk Factors in Gastrointestinal Stromal Tumors: A Systematic Review and Meta-Analysis.
Am Surg
December 2024
Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China.
Background: Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors of the digestive tract. The impact of gastrointestinal bleeding on the prognosis of GISTs remains controversial. This study aims to evaluate the prognostic significance of gastrointestinal bleeding in GIST patients and analyze associated risk factors.
View Article and Find Full Text PDFAuthor's reply to the Letters to the Editor. Six years duration of adjuvant imatinib in high-risk GIST: more to come.
Ann Oncol
December 2024
Institut Gustave Roussy, Villejuif, France.
Duration of adjuvant imatinib treatment in GIST at high risk of relapse.
Ann Oncol
December 2024
Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Türkiye. Electronic address:
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!