Limited resection for duodenal gastrointestinal stromal tumors: Surgical management and clinical outcome

Table 1 Fletcher criteria for risk stratification of gastrointestinal stromal tumors

Risk	Tumor size (cm)	Mitotic count (/50 HPF)
Very low-risk	> 2	< 5
Low-risk	2-5	< 5
Intermediate risk	< 5	6-10
	5 - 10	< 5
High-risk	> 5	> 5
	> 10	any mitotic rate
	any size	> 10

HPF: High-power field.

Table 2 Clinical, anatomical and surgical characteristics of patients with duodenal gastrointestinal stromal tumors

Patient no.	Age (yr)	Sex	Initial symptom	Location	Surgical procedure	Resectional status
1	51	M	Bleeding	2	Open wedge resection + duodenojejunostomy	R0
2	63	M	Bleeding	3	Open wedge resection	R0
3	52	M	Bleeding	1	Laparoscopic wedge resection	R0
4	62	F	Jaundice	1	Pancreatoduodenectomy	R0
5	58	M	Abdominal pain	1	Open wedge resection	R0
6	69	F	Incidental finding	2	Open wedge resecction	R1
7	43	F	Bleeding	4	Segmental resection	R0
8	75	M	Bleeding	3	Open wedge resection	R0
9	49	F	Bleeding	2	Tumor resection without duodenal resection	R1

M: Male; F: Female.

Table 3 Adjuvant therapy, pathological features and follow-up

Patient no.	c-KIT	Tumor size (mm)	Mitotic count (/50 HPF)	Risk	Neoadj. therapy	Adjuvant therapy	Disease relapse	Status
1	pos.	32	5	Low risk	No	No	No	NED at 6 mo
2	pos.	35	14	High risk	No	Imatinib	No	NED at 7 mo
3	pos.	14	1	Very low risk	No	No	No	NED at 13 mo
4	pos.	110	35	High risk	No	No	Liver	Died of PD at 3 mo
5	pos.	30	0	Low risk	No	No	No	NED at 90 mo
6	pos.	25	0	Low risk	No	No	No	NED at 111 mo
7	pos.	110	4	High risk	No	No	No	NED at 92 mo
8	pos.	50	0	Low risk	Imatinib	No	No	Died with NED at 37 mo
9	pos.	80	1	Intermediate	Imatinib	Imatinib	No	NED at 39 mo

HPF: High-power field; NED: No evidence of disease; pos: Positive; PD: Progressive disease.