A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome
Background By reappraising the National Institutes of Health (NIH) consensus criteria, we worked on establishing a modified scheme to identify highly lethal gastrointestinal stromal tumors (GISTs), which have an imperative demand for sequencing analysis to assess the suitability of an adjuvant imati...
Gespeichert in:
| Veröffentlicht in: | Surgery 2007-06, Vol.141 (6), p.748-756 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 756 |
|---|---|
| container_issue | 6 |
| container_start_page | 748 |
| container_title | Surgery |
| container_volume | 141 |
| creator | Huang, Hsuan-Ying, MD Li, Chien-Feng, MD Huang, Wen-Wei, MD Hu, Tsung-Hui, MD Lin, Ching-Nan, MD Uen, Yih-Huei, MD Hsiung, Ching-Yeh, MD Lu, David, MD |
| description | Background By reappraising the National Institutes of Health (NIH) consensus criteria, we worked on establishing a modified scheme to identify highly lethal gastrointestinal stromal tumors (GISTs), which have an imperative demand for sequencing analysis to assess the suitability of an adjuvant imatinib trial. Methods Clinicopathologic features, including NIH and modified schemes, were retrospectively analyzed for 289 patients with localized GISTs. We combined the very low/low-risk GISTs into a single “risk level I” group (≦5 cm, |
| doi_str_mv | 10.1016/j.surg.2007.01.024 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70613673</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606007000931</els_id><sourcerecordid>70613673</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-559fff11ddda683b3e47f715358c0d52e0699b382c818807be992ba56562dbd93</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEoqXwAhyQL3DLMk42_xBCWlVAK1VwAM6WY092Z5vEi8epVF6TF8JmV6rEgdPYmt98Hs83WfZSwkqCrN_uV7z47aoAaFYgV1CsH2XnsiqLvClr-Tg7Byi7vIYazrJnzHsA6NayfZqdyaaqoajkefZ7IyZnaSCjA7lZuEF8ub4Sxs2MMy8sjKeAnrQITvQY4llY4kDzdiHeibBDsaPtbrwXI4adHgUvPWNIQgdPk_Yx4Ywe6RdasdUcvKM5YFJIcLxOMYZlcp7fiU0qt3RHfGom6TtP2790eij3xLdi691yEBFJ-V4zcYLdEoyb8Hn2ZNAj44tTvMh-fPr4_fIqv_n6-fpyc5ObCqqQV1U3DIOU1lpdt2Vf4roZmji_qjVgqwKh7rq-bAvTyraFpseuK3pd1VVd2N525UX25qh78O7nEr-kJmKD46hndAurBmpZ1k0ZweIIGu-YPQ7qNBolQSUr1V4lK1WyUoFU0cpY9OqkvvQT2oeSk3cReH0CNMcBD17PhviBa7s1tOvU5vsjh3EWd4ResSGcDVryaIKyjv7fx4d_ys1Ic9yX8Rbvkfdu8dEbVlJxoUB9S0uXdg6atG-lLP8ABIHXJg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70613673</pqid></control><display><type>article</type><title>A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Huang, Hsuan-Ying, MD ; Li, Chien-Feng, MD ; Huang, Wen-Wei, MD ; Hu, Tsung-Hui, MD ; Lin, Ching-Nan, MD ; Uen, Yih-Huei, MD ; Hsiung, Ching-Yeh, MD ; Lu, David, MD</creator><creatorcontrib>Huang, Hsuan-Ying, MD ; Li, Chien-Feng, MD ; Huang, Wen-Wei, MD ; Hu, Tsung-Hui, MD ; Lin, Ching-Nan, MD ; Uen, Yih-Huei, MD ; Hsiung, Ching-Yeh, MD ; Lu, David, MD</creatorcontrib><description>Background By reappraising the National Institutes of Health (NIH) consensus criteria, we worked on establishing a modified scheme to identify highly lethal gastrointestinal stromal tumors (GISTs), which have an imperative demand for sequencing analysis to assess the suitability of an adjuvant imatinib trial. Methods Clinicopathologic features, including NIH and modified schemes, were retrospectively analyzed for 289 patients with localized GISTs. We combined the very low/low-risk GISTs into a single “risk level I” group (≦5 cm, <5/50 high power fields [HPFs]) and redesignated the intermediate-risk GISTs as “risk level II” (either <5 cm, 6 to 10/50 HPFs or 5 to 10 cm, <5/50 HPFs). The GISTs of “risk level IV” group were >5 cm and >10/50 HPF, with the rest of high-risk GISTs defined as “risk level III.” Results The cumulative 5-year rate of disease-specific survival (DSS) for all 289 patients was 82%, and the DSS rates for patients with GISTs classified as risk levels I to IV were 100%, 96%, 67%, and 25% at 5 years, respectively. The prognostic differences were striking between the risk level II and III groups ( P < .0001) and between the risk level III and IV groups ( P = .0002). The higher risk level of our scheme represented the strongest independent adverse factor (risk ratio [RR] = 11.299 for risk level III; RR = 33.815 for risk level IV; P < .0001), followed by mixed/epithelioid histology (RR = 2.837, P = .003) and older age (≧70 years, RR = 1.955, P = .044). Conclusions Remarkable prognostic heterogeneity exists in the high-risk category of the NIH scheme, which is not as effective as the modified criteria in identifying highly lethal GISTs that we classified as risk level IV.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2007.01.024</identifier><identifier>PMID: 17560251</identifier><identifier>CODEN: SURGAZ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cohort Studies ; Consensus ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Stromal Tumors - classification ; Gastrointestinal Stromal Tumors - diagnosis ; Gastrointestinal Stromal Tumors - pathology ; Gastrointestinal Stromal Tumors - therapy ; General aspects ; Humans ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Prognosis ; Retrospective Studies ; Risk Assessment ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Survival Analysis ; Treatment Outcome ; Tumors ; United States</subject><ispartof>Surgery, 2007-06, Vol.141 (6), p.748-756</ispartof><rights>Mosby, Inc.</rights><rights>2007 Mosby, Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-559fff11ddda683b3e47f715358c0d52e0699b382c818807be992ba56562dbd93</citedby><cites>FETCH-LOGICAL-c505t-559fff11ddda683b3e47f715358c0d52e0699b382c818807be992ba56562dbd93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0039606007000931$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18940849$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17560251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Hsuan-Ying, MD</creatorcontrib><creatorcontrib>Li, Chien-Feng, MD</creatorcontrib><creatorcontrib>Huang, Wen-Wei, MD</creatorcontrib><creatorcontrib>Hu, Tsung-Hui, MD</creatorcontrib><creatorcontrib>Lin, Ching-Nan, MD</creatorcontrib><creatorcontrib>Uen, Yih-Huei, MD</creatorcontrib><creatorcontrib>Hsiung, Ching-Yeh, MD</creatorcontrib><creatorcontrib>Lu, David, MD</creatorcontrib><title>A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background By reappraising the National Institutes of Health (NIH) consensus criteria, we worked on establishing a modified scheme to identify highly lethal gastrointestinal stromal tumors (GISTs), which have an imperative demand for sequencing analysis to assess the suitability of an adjuvant imatinib trial. Methods Clinicopathologic features, including NIH and modified schemes, were retrospectively analyzed for 289 patients with localized GISTs. We combined the very low/low-risk GISTs into a single “risk level I” group (≦5 cm, <5/50 high power fields [HPFs]) and redesignated the intermediate-risk GISTs as “risk level II” (either <5 cm, 6 to 10/50 HPFs or 5 to 10 cm, <5/50 HPFs). The GISTs of “risk level IV” group were >5 cm and >10/50 HPF, with the rest of high-risk GISTs defined as “risk level III.” Results The cumulative 5-year rate of disease-specific survival (DSS) for all 289 patients was 82%, and the DSS rates for patients with GISTs classified as risk levels I to IV were 100%, 96%, 67%, and 25% at 5 years, respectively. The prognostic differences were striking between the risk level II and III groups ( P < .0001) and between the risk level III and IV groups ( P = .0002). The higher risk level of our scheme represented the strongest independent adverse factor (risk ratio [RR] = 11.299 for risk level III; RR = 33.815 for risk level IV; P < .0001), followed by mixed/epithelioid histology (RR = 2.837, P = .003) and older age (≧70 years, RR = 1.955, P = .044). Conclusions Remarkable prognostic heterogeneity exists in the high-risk category of the NIH scheme, which is not as effective as the modified criteria in identifying highly lethal GISTs that we classified as risk level IV.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Consensus</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Stromal Tumors - classification</subject><subject>Gastrointestinal Stromal Tumors - diagnosis</subject><subject>Gastrointestinal Stromal Tumors - pathology</subject><subject>Gastrointestinal Stromal Tumors - therapy</subject><subject>General aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>National Institutes of Health (U.S.)</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>United States</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxiMEoqXwAhyQL3DLMk42_xBCWlVAK1VwAM6WY092Z5vEi8epVF6TF8JmV6rEgdPYmt98Hs83WfZSwkqCrN_uV7z47aoAaFYgV1CsH2XnsiqLvClr-Tg7Byi7vIYazrJnzHsA6NayfZqdyaaqoajkefZ7IyZnaSCjA7lZuEF8ub4Sxs2MMy8sjKeAnrQITvQY4llY4kDzdiHeibBDsaPtbrwXI4adHgUvPWNIQgdPk_Yx4Ywe6RdasdUcvKM5YFJIcLxOMYZlcp7fiU0qt3RHfGom6TtP2790eij3xLdi691yEBFJ-V4zcYLdEoyb8Hn2ZNAj44tTvMh-fPr4_fIqv_n6-fpyc5ObCqqQV1U3DIOU1lpdt2Vf4roZmji_qjVgqwKh7rq-bAvTyraFpseuK3pd1VVd2N525UX25qh78O7nEr-kJmKD46hndAurBmpZ1k0ZweIIGu-YPQ7qNBolQSUr1V4lK1WyUoFU0cpY9OqkvvQT2oeSk3cReH0CNMcBD17PhviBa7s1tOvU5vsjh3EWd4ResSGcDVryaIKyjv7fx4d_ys1Ic9yX8Rbvkfdu8dEbVlJxoUB9S0uXdg6atG-lLP8ABIHXJg</recordid><startdate>20070601</startdate><enddate>20070601</enddate><creator>Huang, Hsuan-Ying, MD</creator><creator>Li, Chien-Feng, MD</creator><creator>Huang, Wen-Wei, MD</creator><creator>Hu, Tsung-Hui, MD</creator><creator>Lin, Ching-Nan, MD</creator><creator>Uen, Yih-Huei, MD</creator><creator>Hsiung, Ching-Yeh, MD</creator><creator>Lu, David, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070601</creationdate><title>A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome</title><author>Huang, Hsuan-Ying, MD ; Li, Chien-Feng, MD ; Huang, Wen-Wei, MD ; Hu, Tsung-Hui, MD ; Lin, Ching-Nan, MD ; Uen, Yih-Huei, MD ; Hsiung, Ching-Yeh, MD ; Lu, David, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-559fff11ddda683b3e47f715358c0d52e0699b382c818807be992ba56562dbd93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Consensus</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Stromal Tumors - classification</topic><topic>Gastrointestinal Stromal Tumors - diagnosis</topic><topic>Gastrointestinal Stromal Tumors - pathology</topic><topic>Gastrointestinal Stromal Tumors - therapy</topic><topic>General aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>National Institutes of Health (U.S.)</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Hsuan-Ying, MD</creatorcontrib><creatorcontrib>Li, Chien-Feng, MD</creatorcontrib><creatorcontrib>Huang, Wen-Wei, MD</creatorcontrib><creatorcontrib>Hu, Tsung-Hui, MD</creatorcontrib><creatorcontrib>Lin, Ching-Nan, MD</creatorcontrib><creatorcontrib>Uen, Yih-Huei, MD</creatorcontrib><creatorcontrib>Hsiung, Ching-Yeh, MD</creatorcontrib><creatorcontrib>Lu, David, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Hsuan-Ying, MD</au><au>Li, Chien-Feng, MD</au><au>Huang, Wen-Wei, MD</au><au>Hu, Tsung-Hui, MD</au><au>Lin, Ching-Nan, MD</au><au>Uen, Yih-Huei, MD</au><au>Hsiung, Ching-Yeh, MD</au><au>Lu, David, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2007-06-01</date><risdate>2007</risdate><volume>141</volume><issue>6</issue><spage>748</spage><epage>756</epage><pages>748-756</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><coden>SURGAZ</coden><abstract>Background By reappraising the National Institutes of Health (NIH) consensus criteria, we worked on establishing a modified scheme to identify highly lethal gastrointestinal stromal tumors (GISTs), which have an imperative demand for sequencing analysis to assess the suitability of an adjuvant imatinib trial. Methods Clinicopathologic features, including NIH and modified schemes, were retrospectively analyzed for 289 patients with localized GISTs. We combined the very low/low-risk GISTs into a single “risk level I” group (≦5 cm, <5/50 high power fields [HPFs]) and redesignated the intermediate-risk GISTs as “risk level II” (either <5 cm, 6 to 10/50 HPFs or 5 to 10 cm, <5/50 HPFs). The GISTs of “risk level IV” group were >5 cm and >10/50 HPF, with the rest of high-risk GISTs defined as “risk level III.” Results The cumulative 5-year rate of disease-specific survival (DSS) for all 289 patients was 82%, and the DSS rates for patients with GISTs classified as risk levels I to IV were 100%, 96%, 67%, and 25% at 5 years, respectively. The prognostic differences were striking between the risk level II and III groups ( P < .0001) and between the risk level III and IV groups ( P = .0002). The higher risk level of our scheme represented the strongest independent adverse factor (risk ratio [RR] = 11.299 for risk level III; RR = 33.815 for risk level IV; P < .0001), followed by mixed/epithelioid histology (RR = 2.837, P = .003) and older age (≧70 years, RR = 1.955, P = .044). Conclusions Remarkable prognostic heterogeneity exists in the high-risk category of the NIH scheme, which is not as effective as the modified criteria in identifying highly lethal GISTs that we classified as risk level IV.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>17560251</pmid><doi>10.1016/j.surg.2007.01.024</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-6060 |
| ispartof | Surgery, 2007-06, Vol.141 (6), p.748-756 |
| issn | 0039-6060 1532-7361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70613673 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cohort Studies Consensus Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Stromal Tumors - classification Gastrointestinal Stromal Tumors - diagnosis Gastrointestinal Stromal Tumors - pathology Gastrointestinal Stromal Tumors - therapy General aspects Humans Male Medical sciences Middle Aged Multivariate Analysis National Institutes of Health (U.S.) Prognosis Retrospective Studies Risk Assessment Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Survival Analysis Treatment Outcome Tumors United States |
| title | A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: A subdivision of the original high-risk group on the basis of outcome |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T17%3A50%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20modification%20of%20NIH%20consensus%20criteria%20to%20better%20distinguish%20the%20highly%20lethal%20subset%20of%20primary%20localized%20gastrointestinal%20stromal%20tumors:%20A%20subdivision%20of%20the%20original%20high-risk%20group%20on%20the%20basis%20of%20outcome&rft.jtitle=Surgery&rft.au=Huang,%20Hsuan-Ying,%20MD&rft.date=2007-06-01&rft.volume=141&rft.issue=6&rft.spage=748&rft.epage=756&rft.pages=748-756&rft.issn=0039-6060&rft.eissn=1532-7361&rft.coden=SURGAZ&rft_id=info:doi/10.1016/j.surg.2007.01.024&rft_dat=%3Cproquest_cross%3E70613673%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70613673&rft_id=info:pmid/17560251&rft_els_id=S0039606007000931&rfr_iscdi=true |