Open AccessThe prognostic value of gastrointestinal bleeding in gastrointestinal stromal tumor: A propensity score matching analysis
Author(s) -
Wan Wenze,
Xiong Zhen,
Zeng Xiangyu,
Yang Wenchang,
Li Chengguo,
Tang Yu,
Lin Yao,
Gao Jinbo,
Zhang Peng,
Tao Kaixiong
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2328
Subject(s) - gist , propensity score matching , medicine , odds ratio , gastroenterology , confounding , stromal tumor , stomach , small intestine , gastrointestinal bleeding , stromal cell
Background and objectives Whether gastrointestinal (GI) bleeding indicates gastrointestinal stromal tumor (GIST) rupture and impacts prognosis is unclear. We examined the prognostic value of GI bleeding in GIST. Methods Primary GIST patients with (GB group) or without (NGB group) initial symptoms of GI bleeding were retrospectively studied. Propensity score matching (PSM) was conducted to reduce confounders. Results Eight hundred patients were enrolled. Male gender [odds ratio (OR) = 1.517, P = 0.011], tumors in the small intestine (OR = 2.539, P < 0.001), and tumor size 5‐10 cm (OR = 2.298, P = 0.004) increased the odds of GI bleeding; age >60 years decreased the odds (OR = 0.683, P = 0.031). After PSM, 444 patients were included (222 in each group). Relapse‐free survival (RFS) ( P = 0.001) and overall survival (OS) ( P = 0.002) were both superior in the GB group. In subgroup analysis, the GB group achieved a superior RFS ( P = 0.005) and OS ( P = 0.007) in patients with small intestine GIST, but not stomach or colorectal GIST. Conclusions GIST patients with age <60, male gender, tumors located in the small intestine, and tumors 5‐10 cm in size had a higher risk of GI bleeding. GIST patients with GI bleeding had a superior RFS and OS. This difference was statistically significant only in small intestine GIST.