1. Prognostic and predictive values of the KIT11-mutated grading system in patients with gastrointestinal stromal tumors: a retrospective study
- Author
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Ling-Jun Song, Wei-Wei Shen, Hui-Juan Ge, and Xiao-Qin Shi
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Stromal cell ,Adolescent ,Gastrointestinal Stromal Tumors ,Antineoplastic Agents ,Gastroenterology ,Disease-Free Survival ,Pathology and Forensic Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,In patient ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,GiST ,business.industry ,Retrospective cohort study ,Middle Aged ,Prognosis ,Predictive value ,Confidence interval ,Proto-Oncogene Proteins c-kit ,030104 developmental biology ,Imatinib mesylate ,030220 oncology & carcinogenesis ,Mutation ,Imatinib Mesylate ,Female ,business - Abstract
Summary The KIT11 mutation is the most frequent mutation pattern in gastrointestinal stromal tumors (GISTs). However, few studies have investigated the correlation between the KIT11-mutated grading system and imatinib mesylate (IM) sensitivity (the first choice for adjuvant treatment of GISTs). Here, we elucidated the clinical value of the KIT11-mutated grading system for prognostic prediction in patients with GISTs treated with IM. A total of 106 patients with GIST were treated with IM (8: intermediate-risk, 98: high-risk; 10: KIT9-mutated, 86: KIT11-mutated, 5: wild-type, and 5: other mutations). KIT11-mutated patients were divided into 3 grades based on the KIT11-mutated site and type. Clinical backgrounds and prognostic outcomes were retrospectively compared between the 3 groups. Of 86 KIT11-mutated patients treated with IM, 32 (37.21%) had grade 1 tumors, 37 (43.02%) had grade 2 tumors, and 17 (19.77%) had grade 3 tumors. The 5-year disease-free survival (DFS) was significantly worse in patients with grade 3 KIT11-mutated GISTs (41.96%, p = 0.001) than in those with grade 1 (93%) and grade 2 (70.64%) cases. The multivariable analysis suggested that the KIT11-mutated grading system was an independent risk factor for DFS in patients treated with IM (hazard risk, 2.512; 95% confidence interval, 1.370–4.607; p = 0.003). In conclusion, the KIT11-mutated grading system provides good prognostic stratification for DFS in patients treated with IM. Grade 1 tumors predict a favorable response to IM.
- Published
- 2020