Clinical Staging System of Woodall et al for Gastrointestinal Stromal Tumors (GIST)

Description

Woodall et al developed a clinical grading system for patients with a gastrointestinal stromal tumor (GIST). This can be used to identify patients who may benefit from more aggressive management. The authors are from the University of Louisville in Kentucky.

Parameters:

(1) tumor differentiation

(2) tumor diameter

(3) metastases

Histologic Differentiation	Grade	G code
well-differentiated	I	G1
moderately differentiated	II	G1
poorly differentiated	III	G2
undifferentiated	IB	G2

Tumor Diameter	T code
<= 70 mm (<= 7 cm)	T1
> 70 cmm (> 7 cm)	T2

Histologic Differentiation	Metastases	Stage
Grade I or II	none (M0)	I
Grade III or IV	none (M0)	II
any	present (M1)	III

where:

• Metastases include spread to lymph nodes.

• According to the Figure 2 the survival curves for Stage II and III are fairly close, suggesting that a 2 stage system might also work.

Additional factors impacting survival:

(1) age (worse survival if >= 65 years of age)

(2) surgical therapy (worse survival if not treated with surgery)

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Description

Specialty

ICD-10