Gastrointestinal Stromal Tümör (GİST) Olgularında Komşu Organ İnvazyonunun Klinik ve Terapötik Etkileri
Öz
Amaç: Bu retrospektif çalışma, gastrointestinal stromal tümör (GİST) olgularında bitişik organ invazyonunun klinik ve terapötik etkilerini araştırmayı amaçlamıştır.
Yöntemler: Ocak 2007 ile Aralık 2020 tarihleri arasında sorumlu araştırmacı tarafından çeşitli merkezlerde ameliyat edilen 114 GİST hastasının dosyaları retrospektif olarak çalışmaya dahil edildi. Hastalar, bitişik organ invazyonu olanlar (n=29) ve olmayanlar (n=85) olmak üzere iki gruba ayrıldı.
Bulgular: İnvazyon ile semptomlar (r=0.271; p<0.01), yerleşim yeri (r=0.274; p<0.01), odak (r=0.277; p<0.01), metastaz öyküsü (r=0.277; p<0.01), postoperatif metastaz (r=0.352; p<0.01), maksimum çap (r=0.311; p<0.01), cerrahi sınır (r=0.311; p<0.01), nüks (r=0.287; p<0.01), postoperatif kan transfüzyonu (r=0.263; p<0.01) ve NIH risk sınıfı (r=0.460; p<0.01) arasında anlamlı bir korelasyon saptandı. Tek değişkenli (univaryat) düzeyde invazyon (OR=1.863; p<0.01), yerleşim yeri (OR=0.463; p<0.05), odak (OR=3.037; p<0.01), maksimum çap (OR=0.012; p<0.05), cerrahi sınır (OR=1.587; p<0.05), preoperatif kan transfüzyonu (OR=2.426; p<0.01), postoperatif kan transfüzyonu (OR=1.710; p<0.05) ve NIH (Ulusal Sağlık Enstitüleri) risk sınıfının (OR=1.568; p<0.05) etkileri anlamlı bulundu. Ancak, çok değişkenli (multivaryat) düzeyde bu faktörlerin komplikasyonlar üzerindeki etkisi anlamsızdı (p>0.05).
Sonuç: Tek değişkenli değerlendirmede invazyon, GİST olgularının cerrahi sürecinde komplikasyonlara neden olabilmektedir. Bu nedenle, invazyonun GİST olgularında postoperatif komplikasyonlar üzerindeki etkisini daha iyi anlamak için daha fazla değişkenin dahil edildiği ileriye dönük (prospektif) çalışmalara ihtiyaç vardır.
Anahtar Kelimeler
Gastrointestinal stromal tümör (GİST), invazyon, tümör, komplikasyon.
Proje Numarası
1
Clinical and Therapeutic Effects of Adjacent Organ Invasion in Gastrointestinal Stromal Tumor (GIST) Cases
Öz
Background: This retrospective study aimed to investigate the clinical and therapeutic effects of adjacent organ invasion in gastrointestinal stromal tumor (GIST) cases.
Methods: The files of 114 GIST patients from various centers who underwent surgery by the principal investigator between January 2007 and December 2020 were retrospectively included. Patients were divided into two groups: those with adjacent organ invasion (n=29) and those without (n=85).
Results: Invasion was significantly correlated with symptoms (r=0.271; p<0.01), location (r=0.274; p<0.01), focus (r=0.277; p<0.01), metastasis history (r=0.277; p<0.01), post operation metastasis (r=0.352; p<0.01), maximum diameter (r=0.311; p<0.01), surgical margin (r=0.311; p<0.01), recurrence (r=0.287; p<0.01), post operation blood transfusion (r=0.263; p<0.01) and NIH (National Institutes of Health) risk class (r=0.460; p<0.01). Effect of invasion (OR=1.863; p<0.01), location (OR=0.463; p<0.05), focus (OR=3.037; p<0.01), maximum diameter (OR=0.012; p<0.05), surgical margin (OR=1.587; p<0.05), preoperative blood transfusion (OR=2.426; p<0.01), post operation blood transfusion (OR=1.710; p<0.05) and NIH risk class (OR=1.568; p<0.05) were significant at univariate level. However, their effects on complication at multivariate level was insignificant (p>0.05). Additionally, exploratory multivariate analysis identified abdominal pain, multiple tumor foci, and high NIH risk class as clinical predictors of adjacent organ invasion itself (p<0.05).
Conclusion: Adjacent organ invasion does not appear to be an independent predictor of postoperative complications in GIST patients. However, its association with specific clinical markers warrants consideration for preoperative risk assessment and surgical planning. Therefore, more prospective studies with more variables are needed to better understand the impact of invasion on postoperative complications in GIST cases.
Anahtar Kelimeler
Gastrointestinal stromal tumor (GIST), invasion, tumor, complication.
Destekleyen Kurum
All financial expenses are covered by the authors. There is no financial support.
Proje Numarası
1
Etik Beyan
The research permission was obtained from the Üsküdar University Non-Interventional Research Ethics Committee with 61351342/020-61 number and 31/07/2025 date. Informed consent to participate was not obtained from all of the participants in the study, because the study was based on mortality and screening from retrospective files. Every technique was carried out in compliance with the applicable rules and regulations. The Üsküdar University Non-Interventional Research Ethics Committee waived the requirement for informed consent to participate because the study was retrospective in nature. The research was conducted according to Helsinki Declaration and Good Clinics guidelines.
Teşekkür
None.