Liu Luojie, Shao Xinyu
Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Department of Gastroenterology, Gusu School, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China.
Surg Endosc. 2024 Dec;38(12):7298-7308. doi: 10.1007/s00464-024-11346-0. Epub 2024 Oct 14.
Subcutaneous gastrointestinal stromal tumors (scGISTs) are extremely rare tumors, and the analysis of their long-term prognosis remains unreported. Therefore, our objective is to analyze the long-term prognosis of patients with scGISTs using the Surveillance, Epidemiology, and End Results database.
Patients diagnosed with GISTs between 2000 and 2019 were included in the study. To handle missing data, multiple imputation techniques were employed. Kaplan-Meier analysis and Cox proportional hazards models were used to evaluate overall survival (OS) and cancer-specific survival (CSS), and subgroup analyses were conducted for various variables.
A total of 12,882 patients were enrolled, with 12,636 diagnosed with GISTs and 246 with scGISTs. In comparison to GISTs patients, scGISTs patients exhibited inferior OS [hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.45-1.98, P < 0.001] and CSS (HR 2.16, 95% CI 1.78-2.61, P < 0.001). Across various subgroups, including age, sex, surgical intervention, marital status, and chemotherapy, scGISTs patients consistently demonstrated significantly poorer OS and CSS outcomes compared to GISTs patients (P < 0.05). The 1-, 3-, and 5-year OS rates for scGISTs patients were 78.4%, 60.3%, and 49.3%, respectively, with corresponding CSS rates of 83.3%, 67.8%, and 57.4%. Notably, scGISTs patients who received surgical treatment had significantly higher 5-year OS rates (62.1% vs 30.9%, P < 0.001) and CSS rates (67.8% vs 40.0%, P < 0.001) compared to those who did not undergo surgery. Multivariate Cox regression analysis identified age, surgical status, and mitotic rate as risk factors influencing OS in scGISTs patients, while surgical status and mitotic rate were identified as risk factors affecting CSS.
Compared to GISTs patients, scGIST patients exhibit a less favorable prognosis; nonetheless, surgical intervention has been demonstrated to enhance their prognosis.
皮下胃肠道间质瘤（scGISTs）是极为罕见的肿瘤，其长期预后分析尚无报道。因此，我们的目的是利用监测、流行病学和最终结果数据库分析scGISTs患者的长期预后。
纳入2000年至2019年期间诊断为胃肠道间质瘤（GISTs）的患者。为处理缺失数据，采用了多重填补技术。采用Kaplan-Meier分析和Cox比例风险模型评估总生存期（OS）和癌症特异性生存期（CSS），并对各种变量进行亚组分析。
共纳入12882例患者，其中12636例诊断为GISTs，246例诊断为scGISTs。与GISTs患者相比，scGISTs患者的OS较差[风险比（HR）1.69，95%置信区间（CI）1.45-1.98，P＜0.001]，CSS也较差（HR 2.16，95%CI 1.78-2.61，P＜0.001）。在包括年龄、性别、手术干预、婚姻状况和化疗在内的各个亚组中，scGISTs患者的OS和CSS结果始终显著差于GISTs患者（P＜0.05）。scGISTs患者的1年、3年和5年OS率分别为78.4%、60.3%和49.3%，相应的CSS率分别为83.3%、67.8%和57.4%。值得注意的是，接受手术治疗的scGISTs患者的5年OS率（62.1%对30.9%，P＜0.001）和CSS率（67.8%对40.0%，P＜0.001）显著高于未接受手术的患者。多因素Cox回归分析确定年龄、手术状态和有丝分裂率是影响scGISTs患者OS的危险因素，而手术状态和有丝分裂率是影响CSS的危险因素。
与GISTs患者相比，scGISTs患者的预后较差；尽管如此，手术干预已被证明可改善其预后。
