Second Department of Surgery, Democritus University of Thrace Medical School, Alexandroupoli, Greece.
University of Pittsburgh Medical Center, Department of Medicine, Pittsburgh, PA, USA.
Am J Surg. 2018 Sep;216(3):492-497. doi: 10.1016/j.amjsurg.2018.04.011. Epub 2018 Apr 19.
The liver is the most common metastatic site in patients with gastrointestinal stromal tumors (GISTs). The purpose of this study is to identify the incidence and predictive factors associated with synchronous liver metastases among patients with GISTs.
A retrospective review of the Surveillance Epidemiology and End Results (SEER) database was performed.
Overall, 2757 patients were identified, of which 276 (10%) had synchronous liver metastases. The two-year survival of patients with synchronous liver metastases was 31.9% overall and 37.1% after undergoing surgery with curative intent. Primary tumor size >5 cm (5-10 cm: OR 2.97, 95% CI: 1.03-8.55, p = 0.044, >10 cm: OR 5.59, 95% CI: 1.95-16.07, p = 0.001), presence of nodal metastases (OR 4.09, 95% CI: 2.01-8.33, p < 0.001) and mitotic count >5/50 HPF (OR 1.58, 95% CI: 1.01-2.47, p = 0.044) were associated with the presence of liver metastases.
One out of ten patients with GISTs presents with hepatic metastases. Primary tumor size >5 cm, presence of nodal metastases and mitotic count >5/50 HPF are associated with a higher risk of synchronous hepatic metastases.
肝脏是胃肠道间质瘤（GIST）患者最常见的转移部位。本研究旨在确定 GIST 患者中同时性肝转移的发生率和相关预测因素。
对监测、流行病学和最终结果（SEER）数据库进行回顾性分析。
共纳入 2757 例患者，其中 276 例（10%）存在同时性肝转移。同时性肝转移患者的两年总生存率为 31.9%，有根治性手术意愿的患者为 37.1%。原发肿瘤直径＞5cm（5-10cm：OR 2.97，95%CI：1.03-8.55，p=0.044；＞10cm：OR 5.59，95%CI：1.95-16.07，p=0.001）、存在淋巴结转移（OR 4.09，95%CI：2.01-8.33，p＜0.001）和核分裂象计数＞5/50HPF（OR 1.58，95%CI：1.01-2.47，p=0.044）与肝转移的发生相关。
十分之一的 GIST 患者初诊时即合并肝转移。原发肿瘤直径＞5cm、存在淋巴结转移和核分裂象计数＞5/50HPF 与同时性肝转移风险增加相关。
