Prognostic Impact of Metastasis Timing in Metastatic Gastrointestinal Stromal Tumors: A Multicenter Retrospective Cohort Study.

IF 3.2 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2026-07-03 eCollection Date: 2026-09-01 DOI:10.1002/ags3.70245

Kunihiko Kawai, Tsuyoshi Takahashi, Ryugo Teranishi, Shinsuke Sato, Yukinori Kurokawa, Toshirou Nishida, Seiichi Hirota, Jyunya Fujita, Yuichiro Doki, Toshimasa Tsujinaka

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Abstract

Background: Gastrointestinal stromal tumors (GISTs) commonly metastasize to the liver and peritoneum. Metastases may be detected synchronously at the time of initial diagnosis or develop metachronously after curative-intent resection. Nonetheless, the prognostic significance of metastasis timing in advanced GIST remains unclear.

Methods: We retrospectively analyzed 147 patients with metastatic GIST treated at multiple institutions between 2003 and 2012. The patients were categorized into synchronous (n = 51) and metachronous (n = 96) groups. Clinicopathological characteristics and overall survival (OS) were compared using Kaplan-Meier analysis and Cox proportional hazards models. Among patients with metachronous disease, the outcomes were further evaluated according to the recurrence interval.

Results: The median OS was significantly shorter in the synchronous group (6.7 years) than in the metachronous group (12.8 years; p = 0.001). Metastasis timing remained an independent prognostic factor in multivariable analysis (hazard ratio 2.36, 95% confidence interval 1.39-4.00; p = 0.001). Among patients with metachronous metastasis, early recurrence within 2 years after surgery was associated with significantly inferior survival compared to late recurrence.

Conclusion: Metastasis timing was associated with survival in patients with metastatic GIST. Both synchronous presentation and early metachronous recurrence were associated with poorer outcomes.

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转移性胃肠道间质瘤转移时间对预后的影响：一项多中心回顾性队列研究。

背景：胃肠道间质瘤（gist）通常转移到肝脏和腹膜。转移可能在最初诊断时同步检测到，或在治疗目的切除后同步发展。然而，晚期GIST转移时间的预后意义尚不清楚。方法：我们回顾性分析了2003年至2012年间在多个机构治疗的147例转移性GIST患者。将患者分为同步组（n = 51）和异时组（n = 96）。采用Kaplan-Meier分析和Cox比例风险模型比较临床病理特征和总生存期（OS）。在异时性疾病患者中，根据复发间隔进一步评估预后。结果：同步组的中位生存期（6.7年）明显短于非同步组（12.8年，p = 0.001）。在多变量分析中，转移时间仍然是一个独立的预后因素（风险比2.36,95%可信区间1.39-4.00;p = 0.001）。在异时转移患者中，术后2年内早期复发与晚期复发相比，生存率明显较低。结论：转移时间与转移性GIST患者的生存相关。同步表现和早期异时复发均与较差的预后相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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