Feng Yunfu, Liu Luojie
Department of Endoscopy Center, The First People's Hospital of Kunshan, Suzhou, China.
Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Surg Endosc. 2025 May;39(5):2911-2924. doi: 10.1007/s00464-025-11600-z. Epub 2025 Mar 18.
Peritoneal and retroperitoneal gastrointestinal stromal tumors (PRGISTs) are exceedingly uncommon, and their clinicopathological characteristics and long-term prognosis remain unreported. Therefore, our objective is to analyze these aspects of patients with PRGISTs using the Surveillance, Epidemiology, and End Results (SEER) database.
Patients diagnosed with PRGISTs and small intestine stromal tumors (SISTs) between 2000 and 2019 were included in the study. Differences between groups were compared using Chi-square tests. Kaplan-Meier analysis and Cox proportional hazards models were used to evaluate overall survival (OS) and cancer-specific survival (CSS).
A total of 3817 patients were enrolled, with 3513 diagnosed with SISTs and 304 with PRGISTs. Compared to SISTs, PRGISTs patients were older, with larger tumors, higher mitotic rates, and greater risk of lymph node (5.3%) and distant (30.6%) metastasis (P < 0.001). Multivariate analysis identified N stage and mitotic rate as risk factors for distant metastasis in PRGISTs. In comparison to SISTs, PRGISTs patients exhibited a significantly worse OS (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.57-2.15, P < 0.001) and CSS (HR 2.11, 95% CI 1.73-2.58, P < 0.001). Subgroup analyses by age, sex, surgical status, chemotherapy, and marital status consistently demonstrated poorer OS and CSS for PRGISTs patients compared to SISTs patients (P < 0.05). The 1-, 3-, 5-, and 10-year OS rates for PRGISTs patients were 77.9%, 61.6%, 51.6%, and 32.8%, respectively, with corresponding CSS rates of 84.5%, 71.7%, 63.3%, and 49.0%. Multivariate Cox regression analysis identified age, race, surgical status, and mitotic rate as risk factors influencing OS, while race, surgical status, and mitotic rate were identified as risk factors affecting CSS.
In comparison to SISTs, PRGISTs patients exhibit distinct clinicopathological features and have a worse prognosis. However, surgical intervention can improve the prognosis of PRGISTs patients.
腹膜和腹膜后胃肠道间质瘤（PRGISTs）极为罕见，其临床病理特征及长期预后尚无报道。因此，我们的目标是利用监测、流行病学和最终结果（SEER）数据库分析PRGISTs患者的这些方面。
纳入2000年至2019年间诊断为PRGISTs和小肠间质瘤（SISTs）的患者。采用卡方检验比较组间差异。使用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）。
共纳入3817例患者，其中3513例诊断为SISTs，304例诊断为PRGISTs。与SISTs相比，PRGISTs患者年龄更大，肿瘤更大，有丝分裂率更高，淋巴结转移（5.3%）和远处转移（30.6%）风险更高（P＜0.001）。多因素分析确定N分期和有丝分裂率是PRGISTs远处转移的危险因素。与SISTs相比，PRGISTs患者的OS（风险比[HR]1.83，95%置信区间[CI]1.57-2.15，P＜0.001）和CSS（HR 2.11，95%CI 1.73-2.58，P＜0.001）显著更差。按年龄、性别、手术状态、化疗和婚姻状况进行的亚组分析一致显示，与SISTs患者相比，PRGISTs患者的OS和CSS更差（P＜0.05）。PRGISTs患者的1年、3年、5年和10年OS率分别为77.9%、61.6%、51.6%和32.8%，相应的CSS率分别为84.5%、71.7%、63.3%和49.0%。多因素Cox回归分析确定年龄（2.11，95%CI 1.73-2.58，P＜0.001）、种族、手术状态和有丝分裂率是影响OS的危险因素，而种族、手术状态和有丝分裂率是影响CSS的危险因素。
与SISTs相比，PRGISTs患者表现出独特的临床病理特征，预后更差。然而，手术干预可改善PRGISTs患者的预后。
