Guo Xiaodan, Huang Shaoqing, Yang Shaohua, Xia Yanzhe, Wu Chunhui, Cai Shirong, He Yulong, Zhou Xuefu, Zhang Xinhua
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Center for Digestive Disease, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Future Oncol. 2025 Jun;21(13):1655-1662. doi: 10.1080/14796694.2025.2499431. Epub 2025 May 5.
Lymph node metastasis (LNM) of gastrointestinal stromal tumors (GISTs) rarely occurs, and lymphadenectomy is not routinely performed in GIST resection. To date, the relevant characteristics and prognosis of GIST patients with LNM are not well known.
From January 2010 to December 2021, GIST patients who underwent lymph node resection were enrolled from a GIST referral center. All patients were divided into either the LN- group (GISTs without LNM) or the LN+ group (GISTs with LNM). The clinicopathological features and follow-up data were analyzed. Propensity score matching (PSM) was conducted to reduce bias caused by confounders.
Out of 1024 surgical patients, 198 patients (age, 52.23 ± 13.54 years; 56.6% males) underwent GIST resection with lymph node dissection for lymphadenopathy, and 17 patients had lymph node metastases (17/1024, 1.66%; 17/198, 8.59%). The LN+ group had a higher mitotic count ( = 0.012) and a higher proportion of distant metastasis ( < 0.001) than the LN- group. After PSM, 28 patients were included (18 in LN- group and 10 in LN+ group). The LN- group had both longer postoperative progression-free survival (PFS, not reached vs. 15.0 months, = 0.002) and overall survival (OS) than the LN+ group, but the difference in OS was not statistically significant (not reached vs. 35.0 months, = 0.069).
The rate of LNM in GISTs is low. LNM may be a less common form of distant metastasis. Moreover, GIST with LNM has an unfavorable prognosis. Further studies are warranted to identify GISTs with lymph node involvement and the potential involved mechanism.
胃肠道间质瘤（GIST）很少发生淋巴结转移（LNM），在GIST切除术中通常不进行淋巴结清扫。迄今为止，GIST伴LNM患者的相关特征和预后尚不清楚。
2010年1月至2021年12月，从一个GIST转诊中心纳入接受淋巴结切除的GIST患者。所有患者分为LN-组（无LNM的GIST）或LN+组（有LNM的GIST）。分析临床病理特征和随访数据。进行倾向评分匹配（PSM）以减少混杂因素引起的偏差。
在1024例手术患者中，198例（年龄52.23±13.54岁；男性占56.6%）因淋巴结病变接受了GIST切除及淋巴结清扫，其中17例有淋巴结转移（17/1024，1.66%；17/198，8.59%）。与LN-组相比，LN+组有更高的核分裂象计数（=0.012）和更高的远处转移比例（<0.001）。PSM后，纳入28例患者（LN-组18例，LN+组10例）。LN-组术后无进展生存期（PFS，未达到vs.15.0个月，=0.002）和总生存期（OS）均长于LN+组，但OS差异无统计学意义（未达到vs.35.0个月，=0.069）。
GIST的LNM发生率较低。LNM可能是一种不太常见的远处转移形式。此外，伴LNM的GIST预后不良。有必要进一步研究以识别有淋巴结受累的GIST及其潜在的相关机制。
