GastroClinicopathologic Characteristics of Gastrointestinal Stromal Tumors and Prognostic Importance of Ki-67 Labeling Index: May be a New Prognostic Marker

Abstract

Objective: The biological behavior of gastrointestinal stromal tumors (GISTs) varies widely and it is diffucult to predict their malignant potential with the current risk classification criterias. Therefore, we aimed to analyse the prognostic importance of Ki-67 LI for estimating survival outcomes in patients with GISTs. Methods: For the last 11 years, between 2006 and 2017, who had been treated after surgery were included. A single pathologist re-defined the histologic examples of all cases retrospectively. Results: Totally, 104 patients were included in the study. The median follow-up time was 73 months (range; 6 to 148 months). Seven of the 104 patients (7%) had local recurrence, 26 of the 104 patients (25%) had distant metastases and 11 of the 104 patients (11%) died during the follow-up period. The mean OS was 133 (range; 124 to 141) and the mean DFS was 117 (range; 107 to 127) months for patients. The disease progression or recurrence during follow up and increasing age were the significant prognostic factors for OS. Mitotic count, growth pattern, tumor location and Ki-67 LI were the significant prognostic factors for DFS. According to multivariate analyses, the Ki-67 LI was the only prognostic factor for estimating disease progression or recurrence (p=0.04). Conclusion: The most important prognostic factors that affect OS were the age and disease progression or recurrence of disease. Ki-67 LI was the only prognostic factor for estimating disease progression or recurrence. As the follow-up period increases, we think that Ki-67 LI also will affect overall survival.

Keywords

• Gastrointestinal Stromal Tumors
• Ki-67
• Prognostic factors
• Survival.

Gastrointestinal Stromal Tümörlerin Klinikopatolojik Özellikleri ve Ki-67 proliferasyon İndeksinin Prognostik Önemi: Yeni Bir Prognostik Belirteç Olabilir

Abstract

Amaç: Gastrointestinal stromal tümörler (GIST'ler), gastrointestinal sistemin en sık görülen mezenkimal neoplazmlarıdır. GIST' lerin biyolojik davranışı çok değişkendir ve mevcut risk sınıflandırma kriterleri ile malignite potansiyellerini tahmin etmek oldukça güçtür. Bu nedenle, çalışmamızda GIST' li hastalarda sağ kalım sonuçlarını tahmin etmek için Ki-67’nin prognostik önemini analiz etmeyi amaçladık. Yöntem: 2006 ve 2017 yılları arasında cerrahi sonrası tedavi altına alınan hastalar çalışmaya dahil edildi., Tüm vakaların histolojik örneklerini geriye dönük olarak tek patolog tarafından yeniden değerlendirildi. Bulgular: 104 hasta çalışmaya dahil edildi. Ortalama takip süresi 73 aydı (6- 148 ay). Takip süresince 104 hastanın 7' sinde (% 7) lokal nüks, 26' sında (% 25) uzak metastaz mevcut olup 11' i (% 11) ex idi. Tüm hastalar için ortalama genel sağ kalım (OS) 133 (124-140) aydı. Ortalama hastalıksız sağ kalım (DFS) 117 (107-127) aydı. Takip süresince hastalığın progresyonu, rekürrensi ve yaş artışı OS için önemli prognostik faktörlerdi. Mitoz sayısı, büyüme paterni, tümör yerleşimi ve Ki-67 indeksi DFS için önemli prognostik faktörlerdi. Çok değişkenli analizlere göre, Ki-67 hastalığın ilerlemesi veya nüksünü tahmin etmede tek prognostik faktördü (p = 0.04). Sonuç: OS' yi etkileyen en önemli prognostik faktörler; yaş, hastalık progresyonu veya nüx idi. Ki-67, hastalık progresyonu veya nüksünü tahmin etmede tek prognostik faktördü. Bu sonuçlar ışığında takip süresi uzadıkça Ki-67’nin genel sağ kalımı da etkileyeceğini düşünüyoruz.

Keywords

• Gastrointestinal Stromal Tümör
• Ki-67
• Prognostik faktörler
• Survey

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