Cargando…

The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors

BACKGROUD: The detectable rate of minimal gastric GISTs has continuously increased. While the surveillance and management of GIST <2 cm have been deemed controversial or lack evidence-based approaches.  The aim of the current study is to propose a cut-off value of tumor size for treatment policy...

Descripción completa

Detalles Bibliográficos
Autores principales: Gao, Zhidong, Wang, Chao, Xue, Qian, Wang, Jingtong, Shen, Zhanlong, Jiang, Kewei, Shen, Kai, Liang, Bin, Yang, Xiaodong, Xie, Qiwei, Wang, Shan, Ye, Yingjiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225611/
https://www.ncbi.nlm.nih.gov/pubmed/28077094
http://dx.doi.org/10.1186/s12876-016-0567-4
_version_ 1782493544285470720
author Gao, Zhidong
Wang, Chao
Xue, Qian
Wang, Jingtong
Shen, Zhanlong
Jiang, Kewei
Shen, Kai
Liang, Bin
Yang, Xiaodong
Xie, Qiwei
Wang, Shan
Ye, Yingjiang
author_facet Gao, Zhidong
Wang, Chao
Xue, Qian
Wang, Jingtong
Shen, Zhanlong
Jiang, Kewei
Shen, Kai
Liang, Bin
Yang, Xiaodong
Xie, Qiwei
Wang, Shan
Ye, Yingjiang
author_sort Gao, Zhidong
collection PubMed
description BACKGROUD: The detectable rate of minimal gastric GISTs has continuously increased. While the surveillance and management of GIST <2 cm have been deemed controversial or lack evidence-based approaches.  The aim of the current study is to propose a cut-off value of tumor size for treatment policy and the appropriate timing for endoscopic ultrasonography (EUS) follow-up in the minimal EUS-suspected gastric GIST patients. METHODS: A single-institution retrospective study was performed. 69 patients with EUS-suspected gastric GISTs were studied from November 2008 to March 2015. 69 patients with minimal gastric GISTs ≤2 cm diagnosed by EUS were followed for a mean period of 29 months (range, 12 to 70). An at least 20% increase of the maximal diameter of the tumors was set as a significant change. RESULTS: During follow-up, Of the 69 minimal EUS-suspected GISTs, 16 (23.2%) showed significant changes in size. 11 out of 69 GISTs (15.9%), 6 out of 43 GISTs (14.0%), 7 out of 30 GISTs (23.3%) showed significant changes in size, at 1 year, 2 years, and more than 3 years respectively. The receiver operating characteristic curve analysis showed that the tumor size cut-off was 9.5 mm. Only 4.7 and 3.7% of gastric EUS-suspected GISTs of <9.5 mm in size showed significant changes at 1 year and 2 years, while 9.5% at more than 3 years. 34.6, 31.3 and 55.6% of gastric EUS-suspected GISTs of ≥ 9.5 mm in size showed significant changes at 1 year, 2 years and more than 3 years. CONCLUSIONS: Minimal EUS-suspected GISTs, larger than 9.5 mm may be associated with significant progression. The patients with a ≥ 9.5 mm GIST should have a EUS 6–12months, while <9.5 mm GIST may have a EUS extended to every 2–3 years. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-016-0567-4) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5225611
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-52256112017-01-17 The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors Gao, Zhidong Wang, Chao Xue, Qian Wang, Jingtong Shen, Zhanlong Jiang, Kewei Shen, Kai Liang, Bin Yang, Xiaodong Xie, Qiwei Wang, Shan Ye, Yingjiang BMC Gastroenterol Research Article BACKGROUD: The detectable rate of minimal gastric GISTs has continuously increased. While the surveillance and management of GIST <2 cm have been deemed controversial or lack evidence-based approaches.  The aim of the current study is to propose a cut-off value of tumor size for treatment policy and the appropriate timing for endoscopic ultrasonography (EUS) follow-up in the minimal EUS-suspected gastric GIST patients. METHODS: A single-institution retrospective study was performed. 69 patients with EUS-suspected gastric GISTs were studied from November 2008 to March 2015. 69 patients with minimal gastric GISTs ≤2 cm diagnosed by EUS were followed for a mean period of 29 months (range, 12 to 70). An at least 20% increase of the maximal diameter of the tumors was set as a significant change. RESULTS: During follow-up, Of the 69 minimal EUS-suspected GISTs, 16 (23.2%) showed significant changes in size. 11 out of 69 GISTs (15.9%), 6 out of 43 GISTs (14.0%), 7 out of 30 GISTs (23.3%) showed significant changes in size, at 1 year, 2 years, and more than 3 years respectively. The receiver operating characteristic curve analysis showed that the tumor size cut-off was 9.5 mm. Only 4.7 and 3.7% of gastric EUS-suspected GISTs of <9.5 mm in size showed significant changes at 1 year and 2 years, while 9.5% at more than 3 years. 34.6, 31.3 and 55.6% of gastric EUS-suspected GISTs of ≥ 9.5 mm in size showed significant changes at 1 year, 2 years and more than 3 years. CONCLUSIONS: Minimal EUS-suspected GISTs, larger than 9.5 mm may be associated with significant progression. The patients with a ≥ 9.5 mm GIST should have a EUS 6–12months, while <9.5 mm GIST may have a EUS extended to every 2–3 years. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-016-0567-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-01-11 /pmc/articles/PMC5225611/ /pubmed/28077094 http://dx.doi.org/10.1186/s12876-016-0567-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Gao, Zhidong
Wang, Chao
Xue, Qian
Wang, Jingtong
Shen, Zhanlong
Jiang, Kewei
Shen, Kai
Liang, Bin
Yang, Xiaodong
Xie, Qiwei
Wang, Shan
Ye, Yingjiang
The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title_full The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title_fullStr The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title_full_unstemmed The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title_short The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors
title_sort cut-off value of tumor size and appropriate timing of follow-up for management of minimal eus-suspected gastric gastrointestinal stromal tumors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225611/
https://www.ncbi.nlm.nih.gov/pubmed/28077094
http://dx.doi.org/10.1186/s12876-016-0567-4
work_keys_str_mv AT gaozhidong thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangchao thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT xueqian thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangjingtong thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT shenzhanlong thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT jiangkewei thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT shenkai thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT liangbin thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT yangxiaodong thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT xieqiwei thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangshan thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT yeyingjiang thecutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT gaozhidong cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangchao cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT xueqian cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangjingtong cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT shenzhanlong cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT jiangkewei cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT shenkai cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT liangbin cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT yangxiaodong cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT xieqiwei cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT wangshan cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors
AT yeyingjiang cutoffvalueoftumorsizeandappropriatetimingoffollowupformanagementofminimaleussuspectedgastricgastrointestinalstromaltumors