Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2022; 14(9): 940-949
Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.940
Development of an innovative nomogram of risk factors to predict postoperative recurrence of gastrointestinal stromal tumors
Shi-Hao Guan, Qiong Wang, Xiao-Ming Ma, Wen-Jie Qiao, Ming-Zheng Li, Ming-Gui Lai, Cheng Wang
Shi-Hao Guan, Department of General Surgery, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China
Shi-Hao Guan, Medical College, Qinghai University, Xining 810001, Qinghai Province, China
Qiong Wang, Department of Medical Oncology, The Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
Xiao-Ming Ma, Wen-Jie Qiao, Ming-Zheng Li, Ming-Gui Lai, Cheng Wang, Department of Gastrointestinal Tumor Surgery, The Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
Author contributions: Guan SH is the author of the main idea, conceived and designed the study, collected and analyzed the data, and wrote and revised the manuscript; Wang C conceived and designed the study, collected and analyzed the data and wrote the manuscript; Wang Q and Ma XM participated in drafting and revising the manuscript, and collected the data; Qiao WJ, Li MZ and Lai MG revised the manuscript and analyzed the data. All authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Institutional Research Ethics Board of Qinghai University Affiliated Hospital (Xining, China) and followed the Declaration of Helsinki.
Informed consent statement: All patients signed informed consent forms.
Conflict-of-interest statement: Each author in this paper declares no conflict of interest.
Data sharing statement: No additional data are available.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng Wang, MM, Chief Doctor, Professor, Department of Gastrointestinal Tumor Surgery, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810001, Qinghai Province, China. cheng_wang_vip@163.com
Received: April 14, 2022
Peer-review started: April 14, 2022
First decision: June 10, 2022
Revised: July 2, 2022
Accepted: August 7, 2022
Article in press: August 7, 2022
Published online: September 27, 2022
Processing time: 161 Days and 0.3 Hours
ARTICLE HIGHLIGHTS
Research background

There are many staging systems for gastrointestinal stromal tumors (GISTs), and the risk indicators selected are also different; thus, it is not possible to quantify the risk of recurrence among individual patients.

Research motivation

To develop a nomogram of postoperative recurrence risk factors in GIST patients to further guide individualized treatment.

Research objectives

To investigate the risk factors for postoperative recurrence in GIST patients.

Research methods

We retrospectively analyzed the clinical and pathological data of 130 patients with GIST. The least absolute shrinkage and selection operator regression model and multivariable logistic regression analysis were used to develop a prediction model. The index of concordance (C-index), calibration curve, receiver operating characteristic curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the predictive model.

Research results

The nomogram included tumor site, lesion size, mitotic rate/50 high power fields, Ki-67 index, intracranial necrosis, and age as predictors. The model presented a perfect discrimination with a reliable C-index. The receiver operating characteristic curve indicated a good predictive value. Decision curve analysis showed that the predicting recurrence nomogram was clinically feasible.

Research conclusions

This recurrence nomogram combines tumor site, lesion size, mitotic rate, Ki-67 index, intracranial necrosis, and age and can easily predict patient prognosis.

Research perspectives

We look forward to conducting a multicenter large-sample prospective controlled study in the future to further explore risk factors after GIST surgery, to better guide individualized treatment.