Gastrointestinal stromal tumors: relationship between preoperative CT features and pathologic risk stratification. Issue 6 (December 2021)

• Record Type: Journal Article
• Authors: Grazzini, Giulia; Guerri, Sara; Cozzi, Diletta; Danti, Ginevra; Gasperoni, Silvia; Pradella, Silvia; Miele, Vittorio
• Is Part Of: Tumori. Volume 107:Issue 6(2021)
• Page Start: 556
• Page End: 563
• Publication Date: 2021-12
• Subjects: Gastrointestinal stromal tumors -- computed tomography -- neoplasm recurrence -- risk classification -- risk assessment; Cancer -- Periodicals; 616.994
• DOI: 10.1177/0300891621996447
• Languages: English
• ISSNs: 0300-8916

Abstract

Objective: To investigate a relationship between contrast-enhanced computed tomography (CECT) features of gastrointestinal stromal tumors (GISTs) and risk of relapse according to Miettinen stratified risk classifications. Methods: After ethical committee approval, a retrospective analysis was conducted on the preoperative CECT of patients with pathologically proven GIST undergoing surgery between June 2009 and December 2019. Chi-square analysis was used to evaluate the correlation between Miettinen stratified risk categories and the following imaging features: tumor size and location, growth pattern, margins, type and degree of contrast enhancement, presence of calcifications, necrosis, signs of ulceration/fistulation, internal hemorrhagic foci, enlarged feeding or draining vessels (EFDV), ascites, peritoneal implants, lymphadenopathy, or metastasis. Results: A total of 54 patients (mean age 65 ± 11, 29 men) were included in the study with a total of 56 GISTs. Necrosis, ulceration/fistulation, hemorrhage, margins, enlarged vessels, type of contrast enhancement, and metastasis turned out to be associated with Miettinen risk categories ( p < 0.005). Logistic regression analysis identified the presence of necrosis and EFDV as predictors of pathologic risk of relapse (overall accuracy of 89.3%). Conclusion: Preoperative CECT may be helpful in predicting pathologic risk categories of GISTs, as determined by the Miettinen classification system.