Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival

Abstract Background The prognosis of patients with gastrointestinal stromal tumors (GISTs) is generally evaluated at the time of diagnosis but does not reflect the survival dynamics of patients in the future. Therefore, the purpose of this article was to evaluate the conditional survival (CS) of Chi...

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Autores principales:	Shao-jun Xu, Si-yu Zhang, Ling-yi Dong, Guo-sheng Lin, Yong-jian Zhou
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Gastrointestinal stromal tumors Conditional survival Chinese patients Prognosis Surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/10a9e7a4b91c4725a7c252c8fdb31c23
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spelling	oai:doaj.org-article:10a9e7a4b91c4725a7c252c8fdb31c232021-11-08T11:02:01ZDynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival10.1186/s12885-021-08828-y1471-2407https://doaj.org/article/10a9e7a4b91c4725a7c252c8fdb31c232021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08828-yhttps://doaj.org/toc/1471-2407Abstract Background The prognosis of patients with gastrointestinal stromal tumors (GISTs) is generally evaluated at the time of diagnosis but does not reflect the survival dynamics of patients in the future. Therefore, the purpose of this article was to evaluate the conditional survival (CS) of Chinese patients with GISTs after radical resection. Methods This retrospective study included 451 patients who underwent radical surgery for GISTs. A Cox proportional hazard model was used to evaluate the prognostic factors of disease-free survival (DFS). The 3-year conditional DFS (CDFS3) of patients who survived for x years was expressed as CDFS3=DFS(x + 3)/DFS(x). Results The traditional 3-year DFS rate decreased gradually from 94.0% at 3 years to 77.3% at 7 years, while the CDFS3 rate increased from 94.0 to 95.2% over the survival time of the patients. In addition, classic clinicopathological prognostic factors had different effects on CDFS3, with changes observed in survival time, but these effects were only slight or moderate (\|d\|<0.5). Although multivariate analysis showed that age, sex, mitotic index and tumor rupture were independent risk factors for DFS at baseline, all adverse prognostic factors, except for the mitotic index, lost their predictive significance at 5 years after operation. When the Modified NIH criteria were included, the risk staging was found to be an independent risk factor for recurrence or death. Time-dependent Cox regression analysis showed that the modified NIH criteria independently affected the recurrence or death of GIST patients within 2 years after operation. Conclusion CS provides detailed dynamic survival information about Chinese patients with primary resected GISTs. The mitotic index is of great clinical significance for the monitoring and follow-up of patient populations with a high risk of tumor recurrence or death until 5 years after surgery.Shao-jun XuSi-yu ZhangLing-yi DongGuo-sheng LinYong-jian ZhouBMCarticleGastrointestinal stromal tumorsConditional survivalChinese patientsPrognosisSurgeryNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gastrointestinal stromal tumors Conditional survival Chinese patients Prognosis Surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Gastrointestinal stromal tumors Conditional survival Chinese patients Prognosis Surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Shao-jun Xu Si-yu Zhang Ling-yi Dong Guo-sheng Lin Yong-jian Zhou Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
description	Abstract Background The prognosis of patients with gastrointestinal stromal tumors (GISTs) is generally evaluated at the time of diagnosis but does not reflect the survival dynamics of patients in the future. Therefore, the purpose of this article was to evaluate the conditional survival (CS) of Chinese patients with GISTs after radical resection. Methods This retrospective study included 451 patients who underwent radical surgery for GISTs. A Cox proportional hazard model was used to evaluate the prognostic factors of disease-free survival (DFS). The 3-year conditional DFS (CDFS3) of patients who survived for x years was expressed as CDFS3=DFS(x + 3)/DFS(x). Results The traditional 3-year DFS rate decreased gradually from 94.0% at 3 years to 77.3% at 7 years, while the CDFS3 rate increased from 94.0 to 95.2% over the survival time of the patients. In addition, classic clinicopathological prognostic factors had different effects on CDFS3, with changes observed in survival time, but these effects were only slight or moderate (\|d\|<0.5). Although multivariate analysis showed that age, sex, mitotic index and tumor rupture were independent risk factors for DFS at baseline, all adverse prognostic factors, except for the mitotic index, lost their predictive significance at 5 years after operation. When the Modified NIH criteria were included, the risk staging was found to be an independent risk factor for recurrence or death. Time-dependent Cox regression analysis showed that the modified NIH criteria independently affected the recurrence or death of GIST patients within 2 years after operation. Conclusion CS provides detailed dynamic survival information about Chinese patients with primary resected GISTs. The mitotic index is of great clinical significance for the monitoring and follow-up of patient populations with a high risk of tumor recurrence or death until 5 years after surgery.
format	article
author	Shao-jun Xu Si-yu Zhang Ling-yi Dong Guo-sheng Lin Yong-jian Zhou
author_facet	Shao-jun Xu Si-yu Zhang Ling-yi Dong Guo-sheng Lin Yong-jian Zhou
author_sort	Shao-jun Xu
title	Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
title_short	Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
title_full	Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
title_fullStr	Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
title_full_unstemmed	Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival
title_sort	dynamic survival analysis of gastrointestinal stromal tumors (gists): a 10-year follow-up based on conditional survival
publisher	BMC
publishDate	2021
url	https://doaj.org/article/10a9e7a4b91c4725a7c252c8fdb31c23
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Dynamic survival analysis of gastrointestinal stromal tumors (GISTs): a 10-year follow-up based on conditional survival

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