Clinical evaluation of endoscopic resection for treatment of large gastric stromal tumors

Table 1 Data on gastric stromal tumors of different sizes

Maximum diameter of the tumor		Pathological grade (n)		Targeted drugs (n)		Recurrence or metastasis (n)
		Endoscopy	Surgery	Endoscopy	Surgery	Endoscopy	Surgery
3-5 cm	Low risk (115)	28	87	0/28	4/69	1/28	0/69
	Moderate risk (8)	1	7	0/1	5/7	0	1/7
	High risk (1)	0	1	0	Lost to follow-up	0	Lost to follow-up
5-10 cm	Low risk (22)	6	16	0/6	0/12	1/6	1/12
	Moderate risk (69)	2	67	0/2	34/46	0	0/46
	High risk (15)	0	15	0	12/14	0	3/14
≥ 10 cm	Low risk (0)	0	0	0	0	0	0
	Moderate risk (1)	0	1	0	1/1	0	0/1
	High risk (30)	0	30	0	21/22	0	3/22
Total	261	37	224	0/37	79/171	2/37	8/171
P-value		aP < 0.05		bP < 0.01		0.693

^aP < 0.05: Endoscopy vs Surgery in high-risk patients.

^bP < 0.01: Endoscopy vs Surgery in patients receiving targeted drugs.

Table 2 Data for gastric stromal tumors of different volumes

Maximum diameter of the tumor		Pathological grade (n)		Targeted drugs (n)		Recurrence or metastasis (n)
		Endoscopy	Surgery	Endoscopy	Surgery	Endoscopy	Surgery
< 27 cm3	Low risk	24	39	0/24	1/24	1/24	0/26
	Moderate risk	1	2	0/1	2/2	0/1	0/2
	High risk	0	0	0	0	0	0
27-125cm3	Low risk	10	64	0/10	4/52	1/10	1/52
	Moderate risk	2	34	0/2	20/28	0/2	1/28
	High risk	0	7	0	5/6	0	2/6
125-1000 cm3	Low risk	0	0	0	0	0	0
	Moderate risk	0	39	0	20/26	0	0/26
	High risk	0	24	0	18/21	0	2/21
≥ 1000 cm3	Low risk	0	0	0	0	0	0
	Moderate risk	0	0	0	0	0	0
	High risk	0	15	0	9/10	0	2/10
Total	261	37	224	0/37	79/171	2/37	8/171
P-value		cP < 0.05		bP < 0.01		0.693

Table 3 Characteristics of preoperative examination of gastric stromal tumors with different pathological grades

Pathological grade	Tumor volume	Ulcer bleeding	Liquefaction	None1	Both2
Low risk	< 27 cm3 (63)	11/49	1/49	36/49	1/49
	27-125cm3 (74)	18/48	10/48	19/48	1/48
	125-1000 cm3 (0)	0	0	0	0
	≥ 1000 cm3 (0)	0	0	0	0
Moderate risk	< 27 cm3 (3)	1/3	0/3	2/3	0/3
	27-125cm3 (36)	17/28	7/28	2/28	2/28
	125-1000 cm3 (39)	5/19	3/19	7/19	4/19
	≥ 1000 cm3 (0)	0	0	0	0
High risk (46)	< 27 cm3 (0)	0	0	0	0
	27-125cm3 (7)	1/5	0/5	1/5	3/5
	125-1000 cm3 (24)	6/14	0/14	1/14	7/14
	≥ 1000 cm3 (15)	0/2	0/2	0/2	2/2
P-value		1.15	0.62	eP < 0.05	dP < 0.01

None¹: No ulcer bleeding or tumor liquefaction. Both²: Ulcer bleeding and tumor liquefaction. Low-risk stromal tumors vs medium-risk stromal tumors, moderate risk vs high risk, and low risk vs high risk were found to be statistically significant (^fP < 0.01, ^gP < 0.05, ^hP < 0.01).

Table 4 Clinical data for 10 patients with recurrence

Surgical method	Maximum diameter	Volume	Pathological grade	Operation data	Follow-up time (mo)	Medication time (mo)	Liquefaction	Ulcer bleeding
Endoscopy group	5	37.5	Low risk	2012/3/26	41	No	No	No
	3	18.75	Low risk	2017/10/27	6	No	No	No
Surgery group	5	56.25	Low risk	2014/12/9	34	No	No	Yes
	4	40	Moderate risk	2017/2/11	17	No	Yes	No
	7	147	High risk	2015/1/14	12	12	No	Yes
	7.5	56.25	High risk	2016/6/1	21	21	Yes	Unknown
	8	96	High risk	2017/12/1	6	6	Yes	Yes
	14	700	High risk	2015/8/7	35	No	Yes	Yes
	18.5	1572.5	High risk	2015/4/17	24	18	Yes	Unknown
	20	3840	High risk	2016/2/23	11	6	Yes	Unknown