Copyright
©The Author(s) 2021.
World J Gastroenterol. Sep 28, 2021; 27(36): 6128-6141
Published online Sep 28, 2021. doi: 10.3748/wjg.v27.i36.6128
Published online Sep 28, 2021. doi: 10.3748/wjg.v27.i36.6128
Table 1 Preoperative clinical characteristics of solitary gastrointestinal stromal tumors and multiple gastrointestinal stromal tumors in the entire cohort and after propensity score matching
Parameters | Entire cohort, before matching | P value | Propensity score matched cohort | P value | ||
SGIST, n (%) | MGIST, n (%) | SGIST, n (%) | MGIST, n (%) | |||
All cases | 942 | 41 | 164 | 41 | ||
Age (yr) | 0.450 | 0.889 | ||||
≤ 60 | 516 (54.78) | 20 (48.78) | 82 (50.00) | 20 (48.78) | ||
> 60 | 426 (45.22) | 21 (51.22) | 82 (50.00) | 21 (51.22) | ||
Gender | 0.060 | 0.596 | ||||
Male | 479 (50.85) | 27 (65.85) | 115 (70.12) | 27 (65.85) | ||
Female | 463 (49.15) | 14 (34.15) | 49 (29.88) | 14 (34.15) | ||
BMI (kg/m2) | 0.010 | 0.193 | ||||
BMI < 18.5 | 41 (4.35) | 6 (14.63) | 11 (6.71) | 6 (14.63) | ||
18.5 ≤ BMI < 25 | 501 (53.18) | 19 (46.34) | 94 (57.32) | 19 (46.34) | ||
BMI ≥ 25 | 400 (42.46) | 16 (39.02) | 59 (35.98) | 16 (39.02) | ||
Tobacco use | 0.899 | 0.093 | ||||
No | 704 (74.73) | 31 (75.61) | 101 (61.59) | 31 (75.61) | ||
Yes | 238 (25.27) | 10 (24.39) | 63 (38.41) | 10 (24.39) | ||
Alcohol use | 0.514 | 0.768 | ||||
No | 687 (72.93) | 28 (60.98) | 108 (65.85) | 28 (60.98) | ||
Yes | 255 (27.07) | 13 (31.71) | 56 (34.15) | 13 (31.71) | ||
ASA score | 0.443 | 0.868 | ||||
I/II | 779 (82.70) | 32 (78.05) | 126 (74.83) | 32 (78.05) | ||
III/IV | 163 (17.30) | 9 (21.95) | 38 (23.17) | 9 (21.85) | ||
Comorbidities1 | 0.236 | 1.000 | ||||
Present | 417 (44.27) | 22 (53.66) | 88 (53.66) | 22 (53.66) | ||
Absent | 525 (55.73) | 19 (46.34) | 76 (46.34) | 19 (46.34) | ||
Location | 0.450 | 0.884 | ||||
Gastric | 650 (69.00) | 26 (63.41) | 106 (64.63) | 26 (63.41) | ||
Non-gastric | 292 (31.00) | 15 (36.58) | 58 (35.37) | 15 (36.58) | ||
Chief complaint | ||||||
Abdominal pain | 303 (32.17) | 15 (36.58) | 0.554 | 54 (32.93) | 15 (36.58) | 0.657 |
Abdominal distention | 149 (15.82) | 9 (21.95) | 0.295 | 23 (14.02) | 9 (21.95) | 0.211 |
Hematemesis | 42 (4.46) | 3 (7.32) | 0.429 | 9 (5.49) | 3 (7.32) | 0.710 |
Hematochezia | 167 (17.72) | 9 (21.95) | 0.490 | 34 (20.73) | 9 (21.95) | 0.864 |
Medical examination | 275 (29.19) | 11 (26.83) | 0.744 | 42 (25.61) | 11 (26.83) | 0.906 |
Other | 96 (10.19) | 2 (4.88) | 0.266 | 17 (10.37) | 2 (4.88) | 0.278 |
Table 2 Surgical and postoperative pathological characteristics and treatment of the solitary gastrointestinal stromal tumors and multiple gastrointestinal stromal tumors of the entire cohort and after propensity score matching
Parameters | Entire cohort, before matching | P value | Propensity score matched cohort | P value | ||
SGIST, n (%) | MGIST, n (%) | SGIST, n (%) | MGIST, n (%) | |||
All cases | 942 | 41 | 164 | 41 | ||
Surgical approach | 0.028 | 0.361 | ||||
Open | 458 (48.62) | 27 (65.85) | 94 (57.32) | 27 (65.85) | ||
Laparoscopic | 255 (27.07) | 11 (26.83) | 43 (26.22) | 11 (26.83) | ||
Endoscopic | 229 (24.31) | 3 (7.32) | 27 (14.63) | 3 (7.32) | ||
Blood transfusion | 0.161 | 1.000 | ||||
Yes | 171 (18.15) | 11 (26.83) | 44 (26.83) | 11 (26.83) | ||
No | 771 (81.85) | 30 (73.17) | 120 (73.17) | 30 (73.17) | ||
Tumor size (cm) | 0.007 | 0.200 | ||||
Length ≤ 5 | 575 (61.04) | 15 (36.59) | 74 (45.12) | 15 (36.59) | ||
5 < Length ≤ 10 | 239 (25.37) | 16 (39.02) | 41 (25.00) | 16 (39.02) | ||
Length > 10 | 128 (13.59) | 10 (24.39) | 49 (29.88) | 10 (24.39) | ||
Mitotic index (per 50 HPF) | 0.009 | 0.715 | ||||
0-5 | 724 (76.86) | 27 (65.85) | 101 (61.59) | 27 (65.85) | ||
6-10 | 127 (13.48) | 4 (9.76) | 24 (14.63) | 4 (9.76) | ||
> 10 | 91 (9.66) | 10 (24.39) | 39 (23.78) | 10 (24.39) | ||
Modified NIH risk | 0.044 | 0.486 | ||||
Very low | 210 (22.29) | 4 (9.76) | 29 (17.68) | 4 (9.76) | ||
Low | 291 (30.89) | 9 (21.95) | 30 (18.29) | 9 (21.95) | ||
Intermediate | 147 (15.61) | 8 (19.51) | 22 (13.41) | 8 (19.51) | ||
High | 294 (31.21) | 20 (48.78) | 83 (50.61) | 20 (48.78) | ||
Operate time (min) | 0.336 | 0.627 | ||||
mean ± SD | 139 ± 78 | 151 ± 63 | 145 ± 67 | 151 ± 63 | ||
Median (IQR) | 120 (80-180) | 150 (120-180) | 140 (90-190) | 150 (120-180) | ||
Intraoperative tumor rupture | 0.376 | 0.490 | ||||
Yes | 10 (1.06) | 1 (2.44) | 2 (1.22) | 1 (2.44) | ||
No | 932 (98.94) | 40 (97.56) | 162 (98.78) | 40 (97.56) | ||
Hospitalization time in d | 0.226 | 0.442 | ||||
mean ± SD | 13.55 ± 6.32 | 14.78 ± 7.66 | 13.96 ± 5.69 | 14.78 ± 7.66 | ||
Median (IQR) | 12 (10-15) | 14 (9-16) | 13 (11-16) | 14 (9-16) | ||
Postoperative complications | 0.391 | 0.610 | ||||
Present | 179 (19.00) | 10 (24.39) | 34 (20.73) | 10 (24.39) | ||
Absent | 763 (81.00) | 31 (73.61) | 130 (79.27) | 31 (73.61) | ||
Imatinib treatment | 0.187 | 0.832 | ||||
Yes | 298 (31.63) | 17 (41.46) | 71 (43.29) | 17 (41.46) | ||
No | 644 (68.37) | 24 (58.54) | 93 (56.71) | 24 (58.54) |
Table 3 Univariate and multivariate of the clinicopathological factors for progression-free survival
Characteristics | Univariate analysis | Multivariate analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Age in yr | ||||
≤ 60 | Reference | Reference | ||
> 60 | 1.845 (0.953-3.571) | 0.069 | 1.525 (0.740-3.143) | 0.252 |
Sex | ||||
Female | Reference | |||
Male | 0.913 (0.460-1.809) | 0.793 | ||
Comorbidities | ||||
Absent | Reference | |||
Present | 1.147 (0.606-2.172) | 0.673 | ||
Tumor location | ||||
Gastric | Reference | Reference | ||
Non-gastric | 3.548 (1.847-6.818) | < 0.001 | 3.176 (1.526-6.607) | 0.002 |
Tumor size in cm | 0.001 | 0.035 | ||
Length ≤ 5 | Reference | Reference | ||
5 < Length ≤ 10 | 3.022 (1.117-8.179) | 0.029 | 2.180 (0.716-6.642) | 0.170 |
Length > 10 | 5.848 (2.359-14.499) | < 0.001 | 4.071 (1.375-12.052) | 0.011 |
Mitotic index, per 50 HPF | < 0.001 | 0.001 | ||
0-5 | Reference | Reference | ||
6-10 | 4.094 (1.555-10.777) | 0.004 | 4.108 (1.309-12.897) | 0.015 |
> 10 | 7.859 (3.676-16.799) | < 0.001 | 6.577 (2.540-17.029) | < 0.001 |
Surgical approach | 0.251 | |||
Open | Reference | |||
Laparoscopic | 0.449 (0.174-1.154) | 0.096 | ||
Endoscopic | 0 (0-1.006E+230) | 0.961 | ||
Blood transfusion | ||||
No | Reference | Reference | ||
Yes | 2.176 (1.143-4.145) | 0.018 | 1.569 (0.739-3.332) | 0.241 |
Intraoperative tumor rupture | ||||
No | Reference | Reference | ||
Yes | 6.383 (1.524-26.726) | 0.011 | 4.458 (0.863-23.015) | 0.074 |
Imatinib treatment | ||||
Yes | Reference | Reference | ||
No | 0.584 (0.290-1.178) | 0.133 | 4.608 (2.030-10.461) | < 0.001 |
MGIST | ||||
Absent | Reference | Reference | ||
Present | 2.091 (1.055-4.145) | 0.035 | 2.431 (1.097-5.386) | 0.029 |
Table 4 Univariate and multivariate analysis of the clinicopathological factors for overall survival
Characteristics | Univariate analysis | Multivariate analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Age in yr | ||||
≤ 65 | Reference | |||
> 65 | 1.665 (0.754-3.676) | 0.207 | ||
Gender | ||||
Female | Reference | |||
Male | 1.099 (0.461-2.616) | 0.832 | ||
Comorbidities | ||||
Absent | Reference | |||
Present | 1.061 (0.491-2.291) | 0.881 | ||
Tumor location | ||||
Gastric | Reference | Reference | ||
Non-gastric | 4.428 (1.967-9.965) | < 0.001 | 3.812 (1.577-9.213) | 0.003 |
Tumor size in cm | 0.021 | 0.556 | ||
Length ≤ 5 | Reference | Reference | ||
5 < Length ≤ 10 | 2.279 (0.722-7.189) | 0.160 | 1.381 (0.346-5.519) | 0.648 |
Length > 10 | 4.159 (1.498-11.549) | 0.006 | 2.070 (0.539-7.959) | 0.290 |
Mitotic index, per 50 HPF | < 0.001 | 0.015 | ||
0-5 | Reference | Reference | ||
6-10 | 3.120 (0.913-10.669) | 0.070 | 4.129 (0.963-17.707) | 0.056 |
> 10 | 7.515 (3.045-18.548) | < 0.001 | 6.051 (1.762-20.778) | 0.004 |
Surgical approach | 0.684 | |||
Open | Reference | |||
Laparoscopic | 0.621 (0.213-1.815) | 0.384 | ||
Endoscopic | 0 (0-3.609E+275) | 0.968 | ||
Blood transfusion | ||||
No | Reference | Reference | ||
Yes | 2.832 (1.312-6.113) | 0.008 | 1.298 (0.547-3.082) | 0.554 |
Intraoperative tumor rupture | ||||
No | Reference | Reference | ||
Yes | 5.094 (0.682-38.043) | 0.113 | 3.264 (0.355-30.022) | 0.296 |
Imatinib treatment | ||||
Yes | Reference | Reference | ||
No | 2.952 (1.113-7.831) | 0.030 | 7.841 (2.677-22.693) | < 0.001 |
MGIST | ||||
Absent | Reference | Reference | ||
Present | 2.050 (0.889-4.726) | 0.092 | 2.404 (0.830-6.966) | 0.106 |
- Citation: Wu H, Li C, Li H, Shang L, Jing HY, Liu J, Fang Z, Du FY, Liu Y, Fu MD, Jiang KW, Li LP. Clinicopathological characteristics and longterm survival of patients with synchronous multiple primary gastrointestinal stromal tumors: A propensity score matching analysis. World J Gastroenterol 2021; 27(36): 6128-6141
- URL: https://www.wjgnet.com/1007-9327/full/v27/i36/6128.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i36.6128