■胃肠道(GI)出血是胃肠道间质瘤(GIST)的常见症状之一。尽管一些研究强调了它的预后作用,结论不一致。本研究旨在探讨GIST合并消化道出血患者的预后。
■对2003年1月至2008年12月接受完全切除且未接受伊马替尼辅助治疗的原发性GIST患者进行回顾。Kaplan-Meier方法用于估计无复发生存率(RFS),采用Cox比例风险模型进行多变量分析.进行倾向评分匹配(PSM)以减少混杂因素。对PubMed上已发表的文章进行系统回顾,Embase,Cochrane协作,还进行了Medline数据库,并使用PICOS确定纳入标准(患者,干预,比较,结果,和研究设计)原则。
■总共,84例消化道出血患者和90例无消化道出血患者纳入本研究。中位随访时间为140个月(范围,10-196个月),38例患者发生肿瘤复发/转移。对于所有患者来说,多变量分析表明肿瘤位置[风险比(HR)=3.48,95%置信区间(CI):1.78-6.82,P<0.001],肿瘤大小(HR=1.91,95%CI:1.05-3.47,P=0.035),有丝分裂指数(MI;HR=5.69,95%CI:2.77-11.67,P<0.001),年龄(HR=2.68,95%CI:1.49-4.82,P=0.001)是RFS不良的独立预后因素。然而,消化道出血与RFS无关(HR=1.21,95%CI:0.68-2.14,P=0.518)。PSM之后,每组45例患者,发现消化道出血仍不是独立的预后因素(HR=1.23,95%CI:0.51-2.97,P=0.642)。此外,我们的研究和之前报道的6项研究的汇总结果显示,消化道出血不是独立的预后因素(HR=1.45,95%CI:0.73~2.86,P=0.287).
■在这项研究中,肿瘤位置,肿瘤大小,MI,年龄和年龄是原发性GIST患者行根治性切除术的独立预后因素。然而,消化道出血与RFS恶化无关。
UNASSIGNED: Gastrointestinal (GI) bleeding is one of the common symptoms of GI stromal tumor (GIST). Although several studies have highlighted its prognostic role, conclusions have been inconsistent. This
study aimed to investigate the prognosis of GIST patients with GI bleeding.
UNASSIGNED: Primary GIST patients who underwent complete resection and did not receive adjuvant imatinib therapy from January 2003 to December 2008 were reviewed. The Kaplan-Meier method was used to estimate recurrence-free survival (RFS), and multivariate analysis was performed using the Cox proportional hazard model. Propensity score matching (PSM) was conducted to reduce confounders. A systematic review of the published articles in the PubMed, Embase, Cochrane Collaboration, and Medline databases was also conducted, and the inclusion criteria were determined using PICOS (patients, intervention, comparison, outcomes, and
study design) principles.
UNASSIGNED: In total, 84 patients presenting with GI bleeding and 90 patients without GI bleeding were enrolled in this
study. The median time of follow-up was 140 months (range, 10-196 months), and 38 patients developed tumor recurrence/metastasis. For all patients, the multivariate analysis indicated that tumor location [hazard ratio (HR) =3.48, 95% confidence interval (CI): 1.78-6.82, P<0.001], tumor size (HR =1.91, 95% CI: 1.05-3.47, P=0.035), mitotic index (MI; HR =5.69, 95% CI: 2.77-11.67, P<0.001), and age (HR =2.68, 95% CI: 1.49-4.82, P=0.001) were the independent prognostic factors for poor RFS. However, GI bleeding was not associated with RFS (HR =1.21, 95% CI: 0.68-2.14, P=0.518). After PSM, 45 patients from each group were included, and it was found that GI bleeding was still not the independent prognostic factor (HR =1.23, 95% CI: 0.51-2.97, P=0.642). Moreover, the pooled results of our
study and six previously reported studies showed that GI bleeding was not the independent prognostic factor (HR =1.45, 95% CI: 0.73-2.86, P=0.287).
UNASSIGNED: In this
study, tumor location, tumor size, MI, and age were independent prognostic factors in primary GIST patients who underwent radical resection. However, GI bleeding was not associated with worse RFS.