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Prognostic value of preoperative CT features for disease-free survival in patients with primary gastric gastrointestinal stromal tumors after resection

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A Letter to the Editor to this article was published on 04 February 2023

Abstract

Purpose

Tumor size is an important prognostic factor without consideration of the necrotic and cystic components within tumor for patients with gastrointestinal stromal tumors (GISTs). We aimed to extract the enhancing viable component from the tumor using computed tomography (CT) post-processing software and evaluate the value of preoperative CT features for predicting the disease-free survival (DFS) after curative resection for patients with primary gastric GISTs.

Methods

132 Patients with primary gastric GISTs who underwent preoperative contrast-enhanced CT and curative resection were retrospectively analyzed. We used a certain CT attenuation of 30 HU to extract the enhancing tissue component from the tumor. Enhancing tissue volume and other CT features were assessed on venous-phase images. We evaluated the value of preoperative CT features for predicting the DFS after surgery. Univariate and multivariate Cox regression analyses were performed to find the independent risk factor for predicting the DFS.

Results

Of the 132 patients, 68 were males and 64 were females, with a mean age of 61 years. The median follow-up duration was 60 months, and 28 patients experienced disease recurrence and distant metastasis during the follow-up period. Serosal invasion (p < 0.001; HR = 5.277) and enhancing tissue volume (p = 0.005; HR = 1.447) were the independent risk factors for predicting the DFS after curative resection for patients with primary gastric GISTs.

Conclusion

Preoperative contrast-enhanced CT could be useful for predicting the DFS after the surgery of gastric GISTs, and serosal invasion and enhancing tissue volume were the independent risk factors.

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Abbreviations

GISTs:

Gastrointestinal stromal tumors

CT:

Computed tomography

DFS:

Disease-free survival

3D:

Three-dimensional

ICC:

Interclass and intraclass correlation coefficients

TNM:

Tumor node metastasis

Mean attenuation_T:

Mean attenuation value of total tumor

Mean attenuation_E:

Mean attenuation value of enhancing tissue

RFS:

Recurrence-free survival

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Funding

This paper is supported by China International Medical Foundation (Grant Number Z-2014-07-2003-04).

Author information

Author notes

  1. Xiao-Shan Chen and Wei Yuan have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Xiao-Shan Chen, Yu-Tao Yang, San-Yuan Dong, Li-Heng Liu, Meng-Su Zeng & Sheng-Xiang Rao

  2. Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Xiao-Shan Chen, Yu-Tao Yang, San-Yuan Dong, Li-Heng Liu, Meng-Su Zeng & Sheng-Xiang Rao

  3. Department of Cancer Center, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Xiao-Shan Chen, Wei Yuan, Yu-Tao Yang, San-Yuan Dong, Li-Heng Liu, Meng-Su Zeng, Ying-Yong Hou & Sheng-Xiang Rao

  4. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Wei Yuan & Ying-Yong Hou

  5. Department of CT Collaboration, Siemens Healthineers, Shanghai, China

    Zhi-Han Xu

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  1. Xiao-Shan Chen
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Chen, XS., Yuan, W., Xu, ZH. et al. Prognostic value of preoperative CT features for disease-free survival in patients with primary gastric gastrointestinal stromal tumors after resection. Abdom Radiol 48, 494–501 (2023). https://doi.org/10.1007/s00261-022-03725-9

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