The impact of contour maps on estimating the risk of gastrointestinal stromal tumor recurrence: indications for adjuvant therapy: an analysis of the Kinki GIST registry

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2024-03, Vol.27 (2), p.355-365
• Main Authors: Teranishi, Ryugo, Takahashi, Tsuyoshi, Sato, Shinsuke, Sakurai, Katsunobu, Kishi, Kentaro, Hosogi, Hisahiro, Nakai, Takuya, Kurokawa, Yukinori, Fujita, Junya, Nishida, Toshirou, Hirota, Seiichi, Tsujinaka, Toshimasa
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adjuvant therapy; Antineoplastic Agents - therapeutic use; Cancer Research; Chemotherapy, Adjuvant; Classification; Gastric cancer; Gastroenterology; Gastrointestinal cancer; Gastrointestinal Stromal Tumors - pathology; Health risks; Humans; Imatinib Mesylate - therapeutic use; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - pathology; Oncology; Original; Original Article; Postoperative period; Registries; Retrospective Studies; Risk groups; Stomach Neoplasms - drug therapy; Surgical Oncology
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-023-01444-8

Introduction Contour maps enable risk classification of GIST recurrence in individual patients within 10 postoperative years. Although contour maps have been referred to in Japanese guidelines, their usefulness and role in determining indications for adjuvant therapy is still unclear in Japanese patients. The aims of this study are to investigate the validity of contour maps in Japanese patients with GIST and explore the new strategy for adjuvant therapy. Materials and methods A total of 1426 Japanese GIST patients who were registered to the registry by the Kinki GIST Study Group between 2003 and 2012 were analyzed. Patients who had R0 surgery without perioperative therapy were included in this study. The accuracy of contour maps was validated. Results Overall, 994 patients have concluded this study. Using contour maps, we validated the patients. The 5-year recurrence-free survival rates of patients within the GIST classification groups of 0–10%, 10–20%, 20–40%, 40–60%, 60–80%, 80–90%, and 90–100% were 98.1%, 96.6%, 92.3%, 48.0%, 37.3%, 41.0% and 42.4%, respectively. We confirmed that this classification by contour maps was well reflected recurrence prediction. Further, in the high-risk group stratified by the modified National Institutes of Health consensus criteria (m-NIHC), the 10-year RFS rate was remarkably changed at a cutoff of 40% (0–40% group vs. 40–100% group: 88.7% vs. 50.3%, p