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Lymph node metastases in young patients with gastrointestinal stromal tumor: A nationwide analysis.
Fleming, Andrew M; Herb, Joshua; Stiles, Zachary E; Burkbauer, Laura; Dickson, Paxton V; Glazer, Evan S; Shibata, David; Murphy, Andrew J; Davidoff, Andrew M; Gleeson, Elizabeth; Kim, Hong J; Meyers, Michael O; Stitzenberg, Karyn; Ollila, David W; Deneve, Jeremiah L.
Afiliación
  • Fleming AM; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Herb J; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Stiles ZE; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Burkbauer L; Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
  • Dickson PV; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Glazer ES; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Shibata D; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Murphy AJ; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Davidoff AM; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Gleeson E; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Kim HJ; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Meyers MO; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Stitzenberg K; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Ollila DW; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Deneve JL; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
J Surg Oncol ; 128(8): 1268-1277, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37650827
BACKGROUND: Children, adolescents, and young adults (CAYA) (age ≤39 years) with GIST have high rates of LNM, but their clinical relevance is undefined. This study analyzed the impact of LNM on overall survival (OS) for CAYA with GIST. METHODS: The National Cancer Database was queried for patients with resected GIST and pathologic nodal staging data from 2004-2019. Factors associated with LNM were identified. Survival was assessed stratified by presence of LNM. RESULTS: Of 4420 patients with GIST, 238 were CAYA (5.4%). When compared to older adults, CAYA more often had small intestine primaries (51.8% vs. 36.6%, p < 0.0001), T4 tumors (30.7% vs. 24.5%, p = 0.0275) and pN1 disease (11.3% vs. 4.7%, p < 0.0001). Within a multivariable Cox proportional hazards regression model adjusting for age, comorbid disease, mitotic rate, tumor size, and primary site, LNM were associated with increased hazard of death for older adults (hazard ratio [HR]: 1.83; confidence interval [CI]: 1.35-2.42; p < 0.0001), but not CAYA (HR: 3.38; CI: 0.50-14.08; p = 0.13). For CAYA, only high mitotic rate predicted mortality (HR: 4.68; CI: 1.41-18.37: p = 0.02). CONCLUSIONS: LNM are more commonly identified among CAYA with resected GIST who undergo lymph node evaluations, but do not appear to impact OS as observed in older adults. High mitotic rate remains a predictor of poor outcomes for CAYA with GIST.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tumores del Estroma Gastrointestinal Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Aged / Child / Humans Idioma: En Revista: J Surg Oncol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tumores del Estroma Gastrointestinal Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Aged / Child / Humans Idioma: En Revista: J Surg Oncol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos