Smooth muscle tumors of the gastrointestinal tract: an analysis of prognostic features in 407 cases.

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Abstrakt

Tytuł:: Smooth muscle tumors of the gastrointestinal tract: an analysis of prognostic features in 407 cases.
Autorzy:: Alpert L; University of Chicago, Chicago, IL, USA. .
Al-Sabti R; University of Chicago, Chicago, IL, USA.
Graham RP; Mayo Clinic, Rochester, MN, USA.
Pai RK; Mayo Clinic, Scottsdale, AZ, USA.
Gonzalez RS; Beth Israel Deaconess Medical Center, Boston, MA, USA.
Zhang X; Duke University Medical Center, Durham, NC, USA.
Smith V; Duke University Medical Center, Durham, NC, USA.
Wang HL; UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Westbrook L; UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Goldblum JR; Cleveland Clinic Foundation, Cleveland, OH, USA.
Bakhshwin A; Cleveland Clinic Foundation, Cleveland, OH, USA.
Shetty S; Cleveland Clinic Foundation, Cleveland, OH, USA.
Klimstra DS; Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Shia J; Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Askan G; Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Robert ME; Yale University School of Medicine, New Haven, CT, USA.
Thomas C; Yale University School of Medicine, New Haven, CT, USA.
Frankel WL; The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Alsomali M; The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Hagen C; Medical College of Wisconsin, Milwaukee, WI, USA.
Mostafa ME; Medical College of Wisconsin, Milwaukee, WI, USA.
Feely MM; University of Florida, Gainesville, FL, USA.
Assarzadegan N; University of Florida, Gainesville, FL, USA.
Misdraji J; Massachusetts General Hospital, Boston, MA, USA.
Shih AR; Massachusetts General Hospital, Boston, MA, USA.
Agostini-Vulaj D; University of Rochester Medical Center, Rochester, NY, USA.
Meis JM; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Tang S; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Chatterjee D; Washington University School of Medicine, St. Louis, MO, USA.
Kang LI; Washington University School of Medicine, St. Louis, MO, USA.
Hart J; University of Chicago, Chicago, IL, USA.
Lee SM; University of Chicago, Chicago, IL, USA.
Smith T; Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Yantiss RK; Weill Cornell Medicine, New York, NY, USA.
Hissong EM; Weill Cornell Medicine, New York, NY, USA.
Gao ZH; McGill University, Montreal, Quebec, Canada.
Wu J; McGill University, Montreal, Quebec, Canada.
Resnick MB; Lifespan/The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Wu EY; Lifespan/The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Pai RK; University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Zhao L; Brigham and Women's Hospital, Boston, MA, USA.
Doyle LA; Brigham and Women's Hospital, Boston, MA, USA.
Chopra S; Keck Medical Center, University of Southern California, Los Angeles, CA, USA.
Panarelli NC; Montefiore Medical Center, Bronx, NY, USA.
Hu S; Montefiore Medical Center, Bronx, NY, USA.
Longacre TA; Stanford University, Stanford, CA, USA.
Raghavan SS; Stanford University, Stanford, CA, USA.
Lauwers GY; Moffitt Cancer Center, Tampa, FL, USA.
Ghayouri M; Moffitt Cancer Center, Tampa, FL, USA.
Cooper HS; Fox Chase Cancer Center, Philadelphia, PA, USA.
Nagarathinam R; Fox Chase Cancer Center, Philadelphia, PA, USA.
Bellizzi AM; University of Iowa Health Care, Iowa City, IA, USA.
Kakar S; University of California, San Francisco, San Francisco, CA, USA.
Hosseini M; University of California, San Diego, La Jolla, CA, USA.
Rong J; University of California, San Diego, La Jolla, CA, USA.
Greenson JK; University of Michigan, Ann Arbor, MI, USA.
Lamps LW; University of Michigan, Ann Arbor, MI, USA.
Dong Z; University of Utah, Salt Lake City, UT, USA.
Bronner MP; University of Utah, Salt Lake City, UT, USA.
Źródło:: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2020 Jul; Vol. 33 (7), pp. 1410-1419. Date of Electronic Publication: 2020 Feb 12.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: 2023- : [New York] : Elsevier Inc.
Original Publication: Baltimore, MD : Williams & Wilkins, c1988-
MeSH Terms:: Gastrointestinal Neoplasms/*pathology
Smooth Muscle Tumor/*pathology
Adult ; Aged ; Aged, 80 and over ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Progression-Free Survival
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Grant Information:: UL1 TR001863 United States TR NCATS NIH HHS; P30 CA008748 United States CA NCI NIH HHS; P30 CA013330 United States CA NCI NIH HHS; P30 CA006927 United States CA NCI NIH HHS; P50 CA174521 United States CA NCI NIH HHS; T32 EB021955 United States EB NIBIB NIH HHS
Entry Date(s):: Date Created: 20200214 Date Completed: 20210708 Latest Revision: 20230210
Update Code:: 20240105
PubMed Central ID:: PMC8405135
DOI:: 10.1038/s41379-020-0492-5
PMID:: 32051556
: Czasopismo naukowe

Smooth muscle tumors represent the second most common mural mesenchymal neoplasm in the gastrointestinal tract, but established criteria for prognostic assessment of these tumors are lacking. A large cohort of surgically resected intramural gastrointestinal smooth muscle tumors from 31 institutions was analyzed to identify potential prognostic features. Pathologic features were assessed by expert gastrointestinal and/or soft tissue pathologists at each center. Immunohistochemical confirmation was required. A total of 407 cases from the esophagus (n = 97, 24%), stomach (n = 180, 44%), small bowel (n = 74, 18%), and colorectum (n = 56, 14%) were identified. Patients ranged in age from 19 to 92 years (mean 55 years), with a slight female predominance (57%). Mean tumor size was 5.4 cm, with the largest tumor measuring 29 cm. Disease progression following surgery, defined as local recurrence, metastasis, or disease-related death, occurred in 56 patients (14%). Colorectal tumors were most likely to progress, followed by small bowel and gastric tumors. None of the esophageal tumors in this series progressed. Receiver operator characteristic analysis identified optimal cutoffs of 9.8 cm and 3 mitoses/5 mm 2 for discriminating between progressive and non-progressive tumors. Histologic features strongly associated with progression by univariate analysis included moderate-to-severe atypia, high cellularity, abnormal differentiation (defined as differentiation not closely resembling that of normal smooth muscle), tumor necrosis, mucosal ulceration, lamina propria involvement, and serosal involvement (P < 0.0001 for all features). Age, sex, and margin status were not significantly associated with progression (P = 0.23, 0.82, and 0.07, respectively). A risk assessment table was created based on tumor site, size, and mitotic count, and Kaplan-Meier plots of progression-free survival for each subgroup revealed progression-based tiers. Based on our findings, it appears that nonesophageal gastrointestinal smooth muscle tumors measuring >10 cm and/or showing ≥3 mitoses/5 mm 2 may behave aggressively, and therefore close clinical follow-up is recommended in these cases.

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