Duodenal gastrointestinal stromal tumors: clinicopathological characteristics, surgery, and long-term outcome

BMC Surgery

Jiaping Chen¹  Zhixin Chen¹  Bo Zhang¹  Luyin Han²  Jiaju Chen¹  Yuan Yin¹  Haining Chen¹  Chaoyong Shen¹ 

[1]Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China

[2]Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China

关键词: Prognosis;    Clinicopathological Surgery;    Gastrointestinal stromal tumor;    Duodenum;   

Others  :  1222712
DOI  :  10.1186/s12893-015-0084-3

 received in 2015-01-28, accepted in 2015-08-04,  发布年份 2015

【 摘 要 】

Background

Duodenal gastrointestinal stromal tumors (DGIST) are rare, and data on their management is limited. We here report the clinicopathological characteristics, different surgical treatments, and long-term prognosis of DGIST.

Methods

Data of 74 consecutive patients with DGIST in a single institution from June 2000 to June 2014 were retrospectively analyzed. The overall survival (OS) and recurrence/metastasis-free survival rates of 74 cases were calculated using Kaplan–Meier method.

Results

Out of 74 cases, 42 cases were female (56.76 %) and 32 cases (43.24 %) were male. Approximately 22.97, 47.30, 16.22, and 13.51 % of the tumors originated in the first to fourth portion of the duodenum, respectively, with a tumor size of 5.08 ± 2.90 cm. Patients presented with gastrointestinal bleeding (n = 37, 50.00 %), abdominal pain (n = 25, 33.78 %), mass (n = 5, 6.76 %), and others (n = 7, 9.76 %). A total of 18 patients (24.3 %) underwent wedge resection (WR); 39 patients (52.7 %) underwent segmental resection (SR); and 17 cases (23 %) underwent pancreaticoduodenectomy (PD). The median follow-up was 56 months (1–159 months); 19 patients (25.68 %) experienced tumor recurrence or metastasis, and 14 cases (18.92 %) died. The 1-, 3-, and 5-year recurrence/metastasis-free survival rates were 93.9, 73.7, and 69 %, respectively. The 1-, 3- and 5-year OS were 100, 92.5, and 86 %, respectively. The recurrence/metastasis-free survival rate in the PD group within 5 years was lower than that in the WR group (P = 0.047), but was not different from that in the SR group (P = 0.060). No statistically significant difference was found among the three operation types (P = 0.294).

Conclusions

DGIST patients have favorable prognosis after complete tumor removal, and surgical procedures should be determined by the DGIST tumor location and size.

【 授权许可】

   
2015 Shen et al.

【 图 表 】

Fig. 1.

Fig. 2.

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