Gut Liver.  2013 Nov;7(6):642-647.

Prediction of Risk of Malignancy of Gastrointestinal Stromal Tumors by Endoscopic Ultrasonography

• Kim MN
• Kang SJ
• Kim SG
• Im JP
• Kim JS
• Jung HC
• Song IS

Abstract

BACKGROUND/AIMS
The accurate preoperative prediction of the risk of malignancy of gastrointestinal stromal tumors (GISTs) is difficult. The aim of this study was to determine whether tumor size and endoscopic ultrasonography (EUS) features can preoperatively predict the risk of malignancy of medium-sized gastric GISTs.
METHODS
Surgically resected, 2 to 5 cm gastric GIST patients were enrolled and retrospectively reviewed. EUS features, such as heterogeneity, hyperechoic foci, calcification, cystic change, hypoechoic foci, lobulation, and ulceration, were evaluated. Tumors were grouped in 1 cm intervals. The correlations of tumor size or EUS features with the risk of malignancy were evaluated.
RESULTS
A total of 75 patients were enrolled. The mean tumor size was 3.43+/-0.92 cm. Regarding the risk of malignancy, 51 tumors (68%) had a very low risk, and 24 tumors (32%) had a moderate risk. When the tumors were divided into three groups in 1 cm intervals, the proportions of tumors with a moderate risk were not different between the groups. The preoperative EUS features also did not differ between the very low risk and the moderate risk groups.
CONCLUSIONS
Tumor size and EUS features cannot be used to preoperatively predict the risk of malignancy of medium-sized gastric GISTs. A preoperative diagnostic modality for predicting risk of malignancy is necessary to prevent the overtreatment of GISTs with a low risk of malignancy.

Keyword

Gastrointestinal stromal tumors; Endosonography; Tumor size; Malignant risk

MeSH Terms

Aged
*Endosonography
Female
Gastrointestinal Stromal Tumors/*pathology/surgery/*ultrasonography
Humans
Male
Middle Aged
Mitotic Index
Predictive Value of Tests
Preoperative Period
Retrospective Studies
Risk Assessment
Stomach Neoplasms/*pathology/surgery/*ultrasonography
Tumor Burden