Predictors of DeMatteo et al for Recurrence of a Localized Gastrointestinal Stromal Tumor (GIST) Following Resection

Description

DeMatteo et al identified risk factors associated with recurrence of a localized gastrointestinal stromal tumor (GIST) following. These can help identify a patient who may benefit from more aggressive management. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.

Patient selection: localized GIST completely resected

Parameters:

(1) diameter in centimeters

(2) mitotic rate in 50 high powered microscopic fields (hpf)

(3) anatomic location

Parameter	Finding	Hazard Ratio (HR)
diameter	< 10 cm	1
	>= 10 cm	2.5
mitotic rate per 50 hpf	< 5	1
	>= 5	3
location	stomach or colorectal	1
	small intestine	14.6

where:

• Diameter and mitotic rate are determinants of malignancy.

cumulative hazard ratio for recurrence =

= PRODUCT(HR for each parameter)

Interpretation:

• minimum cumulative HR: 1

• maximum cumulative HR: 109.5

• The higher the cumulative HR the greater the risk of recurrence.

KIT mutations affected prognosis in univariate analysis but not in the multi-variate analysis.

KIT Mutation	Rate of Recurrence
exon 11 point mutations and insertions	lowest
none	intermediate
exon 9	higher rate of recurrence
exon 11 deletions involving W557 and/or K558	higher rate of recurrence

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Description

Specialty

ICD-10