Evolving patterns of gastrointestinal stromal tumor presentation, management, and outcome over three decades: A Middle Eastern retrospective study

Table 4 Management and outcome of gastrointestinal stromal tumor cases based on risk stratification, n (%)

	Low-risk (n = 161)	Intermediate-risk (n = 40)	High-risk (n = 81)
Maximum size of tumor (cm)	5.3 (0.3-23.0)	6.3 (2.3-14.0)	6.4 (0.4-29.0)
Tumor size (cm)
≤ 2	25 (16.0)	0 (0.0)	11 (14.5)
> 2-5	51 (32.7)	13 (32.5)	22 (28.9)
> 5-10	53 (34.0)	24 (60.0)	27 (35.5)
> 10	27 (17.3)	3 (7.5)	16 (21.1)
Mitotic count (HPF) (n = 213)
< 5	98 (79.0)	21 (61.8)	22 (40.0)
6-10	14 (11.3)	11 (32.4)	17 (30.9)
> 10	12 (9.7)	2 (5.9)	16 (29.1)
Tumor necrosis	42 (28.6)	17 (42.5)	32 (42.7)
Management
Complete resection with negative surgical margins	142 (88.2)	40 (100)	59 (72.8)
Complete resection with positive surgical margins	15 (9.3)	0 (0.0)	18 (22.2)
Unresectable	4 (2.5)	0 (0.0)	4 (4.9)
CT guided biopsy	6 (3.7)	2 (5.0)	0 (0.0)
Types of resections
Open	65 (43.0)	18 (47.4)	41 (53.2)
Laparoscopic resection	72 (47.7)	15 (39.5)	27 (35.1)
Robotic resection	14 (9.3)	5 (13.2)	9 (11.7)
Chemotherapy1	68 (42.2)	27 (67.5)	50 (61.7)
Radiation therapy	2 (1.2)	0 (0.0)	1 (1.2)
Blood transfusion (< 24 hours post-operation)	41 (25.5)	9 (22.5)	20 (24.7)
Blood units transfused	1 (1-4)	1 (1-2)	1 (1-4)
Hospital length of stay (days)	7 (1-60)	8.5 (1-32)	8 (1-44)
Follow-up period (months)	32 (1-252)	31 (1-181)	53 (1-250)
Post-operative complications
Bleeding	7 (4.3)	2 (5.0)	2 (2.5)
Infection	5 (3.1)	3 (7.5)	1 (1.2)
Deep vein thrombosis	4 (2.5)	0 (0.0)	1 (1.2)
Anastomotic leaks	2 (1.2)	0 (0.0)	3 (3.7)
Outcome
Disease-free survival	131 (81.4)	36 (90.0)	65 (80.2)
Survived with recurrent/metastatic disease	21 (13.0)	3 (7.5)	6 (7.4)
Died	9 (5.6)	1 (2.5)	10 (12.3)
Incidental post-sleeve gastrectomy	19 (11.8)	0 (0.0)	6 (7.4)
Multiple operations	6 (3.7)	0 (0.0)	7 (8.6)

¹Imatinib.

HPF: High power field; CT: Computerized tomography.