Prognostic value of KIT/PDGFRA mutations in gastrointestinal stromal tumors: a meta-analysis

World Journal of Surgical Oncology

Research

Ping Chen¹  Liang Zong² 

[1] Department of Gastrointestinal Surgery, Su Bei People’s Hospital of Jiangsu Province, Yangzhou University, 225001, Yangzhou, Jiangsu Province, China;Department of Gastrointestinal Surgery, Su Bei People’s Hospital of Jiangsu Province, Yangzhou University, 225001, Yangzhou, Jiangsu Province, China;Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;

关键词: Gastrointestinal stromal tumors;    KIT;    PDGFRA;    Prognosis;    Meta-analysis;   

DOI  :  10.1186/1477-7819-12-71

 received in 2013-11-14, accepted in 2014-03-14,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe postulated relationship between KIT/PDGFRA mutations and their prognostic value in gastrointestinal stromal tumors (GISTs) has generated intense attention during the past decade, despite the fact that a great deal of studies have been conducted on this subject. To provide a strong quantitative estimate of this postulated relationship, we carried out a meta-analysis which combined, compared, and summarized the results of existing relevant studies.MethodsStudies were identified by searching databases and reviewing citations in relevant articles. Of 48 potentially relevant studies, we combined individual patient data from 18 studies which involved 1,487 patients with GISTs, by which we made a comparison between the positive KIT mutation subgroup and the negative KIT mutation subgroup (PDGFRA mutation and wild type). We tabulated and analyzed the patient characteristics from each study, including general information such as age and gender, histopathological parameters, and clinical follow-up outcomes.ResultsKIT mutations, compared with PDGFRA mutations and wild type, showed a marked increased risk not only for tumor size (>5 cm) but also for higher mitotic activity (>5), suggesting that KIT mutations significantly correlated with the National Comprehensive Cancer Network (NCCN) high risk or National Institutes of Health (NIH) high risk (1.74 (95% CI, 1.20 to 2.53) and 2.00 (95% CI, 1.08 to 3.68), respectively). Moreover, higher recurrence and metastasis was observed in GISTs with KIT mutations, revealing its closer correlation with clinical malignant risk (P <0.001 for each, with odds ratio (OR) of 2.06 (95%, 1.37 to 3.11) and 2.77 (95%, 1.64 to 4.67), respectively). High risk or malignant GISTs with KIT mutations had a significantly poorer prognosis, as measured by 3-year overall survival, compared to those with PDGFRA mutations and wild type (0.47 (95% CI, 0.25 to 0.90)).ConclusionsKIT mutations, compared with PDGFRA mutations and wild type, represent a poorer prognostic marker in high risk or malignant GISTs.

【 授权许可】

CC BY   
© Zong and Chen; licensee BioMed Central Ltd. 2014