Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

Table 1 Clinical characteristics of 86 patients with duodenal gastrointestinal stromal tumors, n (%)

Clinical characteristics	Duodenal gastrointestinal stromal tumors
Age (yr)	62.15 (26-87)
Gender
Male	43 (50)
Female	43 (50)
Mitotic figures
≤ 5/50 HPF	47 (60.3)
> 5/50 HPF	31 (39.7)
Tumor size (cm)	6.674 (2.0-28.0)
Surgery type
Local resection	56 (65.1)
Whipple	30 (34.9)
Location
Duodenal bulb	17 (19.8)
Descending part	48 (55.8)
Horizontal part	16 (18.6)
Ascending part	6 (7.0)
Risk grade
Low	27 (33.8)
Medium	11 (13.8)
High	4 2 (52.5)
Lymph node number	13.72 (1-40)
Positive lymph node number	0
Postoperative hospital time (days)	20.96 (5-81)
Abdominal drainage time (days)	16.08 (3-78)
Complications
Yes	20 (23.3)
No	66 (76.7)

Table 2 Immunohistochemical findings in duodenal gastrointestinal stromal tumors, n (%)

Antigen	Negative and weakly positive	Strongly positive
Ki-67	65/77 (84.4)	12/77 (15.6)
CD117	3/82 (3.7)	79/82 (96.3)
CD34	49/83 (59.0)	34/83 (41.0)
DOG1	2/53 (3.8)	51/53 (96.2)
Desmin	68/69 (98.6)	1/69 (1.4)
SMA	68/75 (90.7)	7/75 (9.3)
S100	78/80 (97.5)	2/80 (2.5)
SHDB	3/16 (18.8)	13/16 (81.2)
AE1/AE3	41/41 (100.00)	0/41 (0.00)

Table 3 Clinical characteristics of 86 patients with duodenal gastrointestinal stromal tumors treated with different surgical procedures, n (%)

Clinical characteristics	Local resection (n = 56)	Whipple (n = 30)	χ2	P value
Age (yr)	62.2 (26-83)	62.07 (39-87)		0.960
Gender			1.843	0.175
Male	25 (44.6)	18 (60.0)
Female	31 (55.4)	12 (40.0)
Mitotic figures			0.815	0.367
≤ 5/50 HPF	32 (64.0)	15 (53.6)
> 5/50 HPF	18 (36.0)	13 (46.4)
Tumor size (cm)	6.461 (2.0-28.0)	7.073 (3.0-15)		0.0151
Location			5.734	0.0171
Other parts	30 (53.5)	8 (26.6)
Descending part	26 (46.4)	22 (73.3)
Risk grade			8.103	0.0041
Very low and low	23 (45.1)	4 (13.8)
Medium and high	28 (54.9)	25 (86.2)
Complications			1.174	0.279
No	45 (80.4)	21 (70.0)
Yes	11 (19.6)	9 (30.0)
Postoperative hospital time (days)	15.64 (5-66)	24.08 (4-78)		0.0001
Abdominal drainage time (days)	11.92 (3-42)	31.07 (12-81)		0.0011

¹Statistically significant.

Table 4 Univariate and multivariate logistic analyses of different surgical procedures

Characteristics	Univariate logistics analysis			Multivariate analysis
	OR	95%CI	P value	OR	95%CI	P value
Age (yr)
< 62	Reference
≥ 62	0.538	0.218-1.323	0.177
Gender
Male	Reference
Female	0.990	0.407-2.409	0.983
Tumor size (cm)
< 5.0	Reference			Reference
≥ 5.0	3.286	1.215-8.888	0.0261	1.733	0.383-7.833	0.475
Location
Other parts	Reference			Reference
Descending part	3.173	1.209-8.326	0.0191	2.250	0.777-6.516	0.135
Risk grade
Very low and low	Reference			Reference
Medium and high	5.134	1.560-16.891	0.0071	2.597	0.444-15.179	0.289

¹Statistically significant. OR: Odds ratio.

Table 5 Postoperative complications in patients who underwent different types of surgery

	Local resection (n = 56)	Whipple (n = 30)	χ2	P value
Fistula (n = 4)			2.882	0.09
Yes	1	4
No	55	26
Hemorrhage (n = 5)			0.305	0.887
Yes	4	4
No	52	26
Infection (n = 8)			3.044	0.081
Yes	3	6
No	53	24
Gastroparesis (n = 4)			0.925	0.336
Yes	4	0
No	52	30

Table 6 Clinical characteristics of 48 patients with duodenal gastrointestinal stromal tumors in the descending section treated with different types of surgery, n (%)

Clinical characteristics	Local resection (n = 26)	Whipple (n = 22)	χ2	P value
Age (yr)	64.5 (53.25-77)	62 (58.25-67)		0.621
Gender			0	1
Male	13 (50.0)	11 (50.0)
Female	13 (50.0)	11 (50.0)
Mitotic figures			0.467	0.494
≤ 5/50 HPF	15 (65.2)	11 (55.0)
> 5/50 HPF	8 (34.8)	9 (45.0)
Tumor size (cm)	5.25 (4.0-6.4)	6 (4.625-7.75)		0.164
Risk grade			0.467	0.494
Very low and low	15 (65.2)	11 (55.0)
Medium and high	8 (34.8)	9 (45.0)
Complications			0.138	0.710
No	19 (73.1)	15 (68.2)
Yes	7 (26.9)	7 (31.8)
Postoperative hospital time (days)	13.5 (11-16)	25.5 (18.5-40.75)		0.0001
Abdominal drainage time (days)	10 (9-13)	20 (10.5-33.5)		0.0021

¹Statistically significant.

Table 7 Cox regression analysis of duodenal gastrointestinal stromal tumor patients

Characteristics	Univariate Cox analysis
	Hazard ratio	95%CI	P value
Age (yr)
< 62	Reference
≥ 62	79.97	0.057-1.12 × 105	0.236
Gender
Male	Reference
Female	0.69	0.115-4.142	0.682
Tumor size (cm)
< 5	Reference
≥ 5	3.725	0.416-33.351	0.240
Location
Other parts	Reference
Descending part	0.617	0.103-3.695	0.597
Risk grade
Very low and low	Reference
Medium and high	41.935	0.009-2.002 × 105	0.387

Table 8 Clinical characteristics of patients with synchronous liver metastases

No.	Age	Gender	Primary tumor size (cm)	Liver tumor size (cm)	Mitotic index	Risk grade	Gene mutation
1	60	Male	4.5	11	1-3/50 HPF	Low	c-kit
2	39	Male	16	4.5	8-10/50 HPF	High	c-kit