Li Chen, Wu Hao, Li Han, Wang Quan, Li Yang, Gao Zhi-Dong, Yang Xiao-Dong, Ye Ying-Jiang, Jiang Ke-Wei
Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China.
Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.
Cancer Manag Res. 2021 Feb 17;13:1591-1600. doi: 10.2147/CMAR.S291269. eCollection 2021.
The rectum is a rare site for gastrointestinal stromal tumors (GISTs). Tumors in this critical anatomical site are prone to develop local recurrence, and this occurs at a high level even in low-risk tumors. Previous studies found that high-risk was the most common category in rectal gastrointestinal stromal tumors (RGISTs), and size was the most important factor affecting the long-term prognosis. We aimed to find out the most influential factor on clinical outcomes, and describe demographics, oncological differences, and surgical procedures in patients with poor prognosis.
Data on consecutive patients with RGIST, who were diagnosed at Peking University People's Hospital, Shandong Province Hospital, and The First Affiliated Hospital of Shandong First Medical University from 2010 to 2020, were retrospectively evaluated. Further, a literature search was conducted by retrieving data from PubMed, EMBASE, and the Cochrane Library databases from inception up to March 20, 2020.
In all, 50 patients were diagnosed with RGIST at three medical centers, and 86 published records were finally included in the literature review. Combined analysis of the whole individual patient data showed that 5.5 cm was deemed an appropriate cut-off value for L-RGIST, and that patients usually showed a male predominance (67.59%), younger age at onset (56.61 years), higher operative difficulty, and poorer prognosis.
Separation of patients with large RGIST from general patients may contribute to the recognition of the oncological characteristics and clinical management of this rare type of tumor.
直肠是胃肠道间质瘤（GISTs）的罕见发病部位。该关键解剖部位的肿瘤易于发生局部复发，即使是低风险肿瘤，局部复发率也很高。既往研究发现，高风险是直肠胃肠道间质瘤（RGISTs）最常见的类型，肿瘤大小是影响长期预后的最重要因素。我们旨在找出对临床结局最具影响的因素，并描述预后不良患者的人口统计学特征、肿瘤学差异及手术方式。
回顾性评估2010年至2020年在北京大学人民医院、山东省立医院及山东第一医科大学第一附属医院确诊的连续性RGIST患者的数据。此外，通过检索PubMed、EMBASE和Cochrane图书馆数据库，从建库至2020年3月20日的数据进行文献检索。
三个医疗中心共诊断出50例RGIST患者，文献综述最终纳入86篇发表记录。对所有个体患者数据的综合分析表明，5.5 cm被认为是长径型RGIST的合适截断值，且患者通常以男性为主（67.59%），发病年龄较轻（56.61岁），手术难度较高，预后较差。
将大尺寸RGIST患者与一般患者区分开来，可能有助于认识这种罕见肿瘤类型的肿瘤学特征及临床管理。
