Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2021; 27(36): 6128-6141
Published online Sep 28, 2021. doi: 10.3748/wjg.v27.i36.6128
Clinicopathological characteristics and longterm survival of patients with synchronous multiple primary gastrointestinal stromal tumors: A propensity score matching analysis
Hao Wu, Chen Li, Han Li, Liang Shang, Hai-Yan Jing, Jin Liu, Zhen Fang, Feng-Ying Du, Yang Liu, Meng-Di Fu, Ke-Wei Jiang, Le-Ping Li
Hao Wu, Liang Shang, Zhen Fang, Feng-Ying Du, Yang Liu, Le-Ping Li, Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Chen Li, Ke-Wei Jiang, Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing 100044, China
Han Li, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China
Liang Shang, Le-Ping Li, Department of Digestive Tumor Translational Medicine, Engineering Laboratory of Shandong Province, Shandong Provincial Hospital, Jinan 250021, Shandong Province, China
Liang Shang, Le-Ping Li, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China
Hai-Yan Jing, Department of Pathology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Jin Liu, Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Meng-Di Fu, Department of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Author contributions: All authors helped to perform the research; Wu H and Li C were involved equally in the conception and design; Li H provided clinical advice; Fu MD was involved in the follow-up of patients; Fang Z was involved in preliminary medical record screening and entry; Liu Y was involved in the verification of the included data; Du FY was involved in the drafting of the paper or revising it critically for intellectual content; Jing HY and Jiang KW provided pathology images and supervised the report; Shang L and Li LP were involved in the final approval of the version to be published; All authors agreed to be accountable for all aspects of the work.
Supported by Key Research and Development Program of Shandong Province, No. 2019JZZY010104 and No. 2019GSF108146; Special Foundation for Taishan Scholars Program of Shandong Province, No. ts20190978; and Academic Promotion Programme of Shandong First Medical University, No. 2019QL021.
Institutional review board statement: This study was designed in compliance with the Helsinki Declaration and approved by the Ethics Committee of Shandong Provincial Hospital (SWYX: No. 2021-035).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Le-Ping Li, MD, Full Professor, Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi road, Huaiyin District, Jinan 250021, Shandong Province, China. lileping@sdu.edu.cn
Received: June 19, 2021
Peer-review started: June 19, 2021
First decision: July 14, 2021
Revised: July 26, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 28, 2021
Processing time: 95 Days and 15 Hours
ARTICLE HIGHLIGHTS
Research background

Synchronous primary multiple gastrointestinal stromal tumors (MGISTs) are specific and rare. The diagnosis, treatment and follow-up strategies of MGISTs are not specifically described in guidelines.

Research motivation

Due to the low incidence, there is currently no large-scale demographic survey showing the incidence of MGISTs. Additionally, little is known about the impact of MGISTs on the survival of patients with gastrointestinal stromal tumors (GISTs).

Research objectives

This study aimed to compare the clinicopathological characteristics and prognoses of patients with MGISTs and patients with solitary GISTs (SGISTs).

Research methods

Due to the inhomogeneous distribution of several baseline characteristics and uneven MGIST and SGIST group sizes, propensity score matching was performed according to comorbidities, body mass index, tumor location, mitotic index, sex, age and American Society of Anesthesiologists score.

Research results

Among the entire cohort, the incidence of MGISTs was 4.17%. Patients with MGISTs and those with SGISTs had disparities in body mass index, surgical approach, tumor size and mitotic index. Tumor location, tumor size, mitotic index, imatinib treatment and MGISTs were identified as independent prognostic factors of progression-free survival. However, overall survival was similar between the SGIST and MGIST groups.

Research conclusions

Patients with MGISTs may have demographic characteristics and immunohistochemical markers that are similar to those of patients with SGISTs, but MGIST patients also have unique tumor features. Without specific diagnostic indicators and symptoms, patients with MGISTs were identified as having a poorer progression-free survival than patients with SGISTs.

Research perspectives

Risk criteria, diagnostic strategies and treatment procedures suitable for these tumors of lower morbidity should be developed to achieve personalized precision therapy and maximize the survival benefit of these patients.