Surgical Treatment of Gastric Gastrointestinal Stromal Tumors: Analysis of 92 Operated Patients

Aim: To review and evaluate the clinicopathological factors predictive of recurrence after surgical resection for gastrointestinal stromal tumor ( GIST) of the stomach. Methods: The clinicopathological records of 92 gastric GIST patients who were operated upon at a single institute from 1996 to 2005 were retrospectively reviewed and assessed for recurrence- free survival. Results: The patients included 43 men and 49 women. Their ages ranged from 25 to 91 years. The size of the tumors varied from 0.8 to 47.7 cm (median 5.8; 95% CI 6.4-9.2 cm). All but one operative margin were clear. The follow-up period ranged from 11 to 112 months (median 31, 95% CI 33.7-43.5 months). Fifteen patients (16%) developed disease recurrence, of which liver metastasis was the most common. Only 1 of the patients with tumors ! 4 cm developed recurrence. The 3-year recurrence- free survival rates for patients with tumors smaller or larger than 4 cm were 93 and 56.0%, respectively (p ! 0.01). Multivariate analysis showed that the tumor size was the independent factor that was inversely associated with recurrence-free survival. Conclusion: The tumor size is an important prognostic factor for recurrence after surgery. Early excision is recommended for gastric GISTs even of small size