Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jun 20, 2023; 13(3): 153-165
Published online Jun 20, 2023. doi: 10.5662/wjm.v13.i3.153
Microvessel density in patients with gastrointestinal stromal tumors: A systematic review and meta-analysis
Konstantinos Perivoliotis, Ioannis Baloyiannis, Athina A Samara, Prodromos Koutoukoglou, Panagiotis Ntellas, Katerina Dadouli, Maria Ioannou, Konstantinos Tepetes
Konstantinos Perivoliotis, Ioannis Baloyiannis, Athina A Samara, Konstantinos Tepetes, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Prodromos Koutoukoglou, Katerina Dadouli, Research Methodology in Biomedicine, Biostatistics and Clinical Bioinformatics, University of Thessaly, 41110 41110, Greece
Panagiotis Ntellas, Maria Ioannou, Department of Pathology, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Perivoliotis K, Ntellas P, Baloyiannis I contributed to study conception and design; Dadouli K, Koutoukoglou P contributed to acquisition of data; Perivoliotis K, Ntellas P, Samara A contributed to analysis and interpretation of data; Perivoliotis K, Ntellas P contributed to drafting of manuscript; Ioannou M, Tepetes K contributed to critical revision.
Conflict-of-interest statement: The authors declare no potential conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Athina A Samara, MD, Surgeon, Department of Surgery, University Hospital of Larissa, Mezourlo Hill, Larissa 41110, Greece. at.samara93@gmail.com
Received: January 14, 2023
Peer-review started: January 14, 2023
First decision: April 13, 2023
Revised: April 30, 2023
Accepted: May 16, 2023
Article in press: May 16, 2023
Published online: June 20, 2023
Processing time: 157 Days and 2.9 Hours
Abstract
BACKGROUND

Gastrointestinal stromal tumors (GISTs) are considered the most common mesenchymal tumors of the gastrointestinal tract. Microvessel density (MVD) constitutes a direct method of vascularity quantification and has been associated with survival rates in multiple malignancies.

AIM

To appraise the effect of MVD on the survival of patients with GIST.

METHODS

This study adhered to Systematic reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Electronic scholar databases and grey literature repositories were systematically screened. The Fixed Effects or Random Effects models were used according to the Cochran Q test.

RESULTS

In total, 6 eligible studies were identified. The pooled hazard ratio (HR) for disease free survival (DFS) was 8.52 (95%CI: 1.69-42.84, P = 0.009). The odds ratios of disease-free survival between high and low MVD groups at 12 and 60 mo did not reach statistical significance. Significant superiority of the low MVD group in terms of DFS was documented at 36 and 120 mo (OR: 8.46, P < 0.0001 and OR: 22.71, P = 0.0003, respectively) as well as at metastases rate (OR: 0.11, P = 0.0003).

CONCLUSION

MVD significantly correlates with the HR of DFS and overall survival rates at 36 and 120 mo. Further prospective studies of higher methodological quality are required.

Keywords: Vascularity; Microvessel density; Gastrointestinal stromal; Survival; Meta-analysis

Core Tip: This systematic review and meta-analysis summarize all available data regarding the prognostic role of microvessel density (MVD) in gastrointestinal stromal tumors (GISTs). MVD measurement affects long term GIST survival. However, further prospective studies are necessary.