Analysis Of Gastrointestinal Stromal Tumor Metastatic To Liver Prognostic Factors Of 48 Cases

Objective In order to provide the theoretical and clinical guidance,we try to analysis on 48 cases of patients with gastrointestinal stromal tumor metastatic to liver to study the prognosis of gastrointestinal stromal tumor metastatic to liver.Methods By phone and outpatient service, 48 cases of GIST patients with liver metastases of the first affiliated hospital of fujian medical university were follow-up during the period from 2006.2.1-2014.12.3. Patients were condidered as lost to follow-up who did not more than three times answer the phone.And the last time of the clinic or hospital review were record as the end of time,and the follow-up results were analyzed by using SPSS 19.0 statistical analyzed software.At all,it will have statistically significant for these data with P < 0.05.Results The group 1, 2, 3 year survival rates were 94.91%, 84.28% and 75.33%. Through using the Log Rank and K-M test,we analyzed the single factors such as age, gender, chief complaint,primary site of tumor, maximum transverse diameter of primary tumor, whether primary tumor accept surgery, liver metastases occur Synchronous or metachronous,how long the time of liver metastasis occurs heterochrony,whether the site of liver metastases accept surgery, the number of the tumor of liver metastases, the distribution of liver metastases tumors,whether accept targeted therapy, whether tumor is necrosis, whether coated is complete, CD117 and CD34,whether accept combination therapy.We calculated the results show that the smaller maximum transverse diameter of primary tumor, the better prognosis(c2=3.30,P=0.004), the primary site accepted R0 surgical resection have the better prognosis(c2 = 11.15, P = 0.000),liver metastases accepted R0 surgical resection have the better prognosis than those accepted R1 or R2 surgical resection(c2 = 12.35, P = 0.000), metachronous gastrointestinal stromal tumor Metastatic to Liver have better prognosis than Synchronous gastrointestinal stromal tumor Metastatic to Liver(c2 = 12.95, P = 0.000),the lower risk of the gastrointestinal stromal tumor liver metastases grading, the better prognosis(c2 = 15.10, P = 0.002),patients accepted targeted therapy than those without accepted targeted therapy have better prognosis(c2 = 8.21, P = 0.041),targeted therapy in combined with surgical treatment,patients would have significant impact for prognosis(c2 = 17.20, P = 17.20).Applying COX regression model analysis of related factors to analyze multiple factors,we study that targeted therapy, hepatic metastasis timeliness,accepted R0 surgrical resection for liver metastases and targeted therapy in combined with surgical treatment are the independent factors for survival time and prognosis.Conclusion The maximum transverse diameter of primary tumor, the site of primary and liver metastases tumor accepted R0 surgical resection, metachronous gastrointestinal stromal tumor,the classification of risk, targeted therapy and targeted therapy in combined with surgical treatment are the important impacts for gastrointestinal stromal tumor metastatic to liver prognostic.we can provide individualized and comprehensive treatment for patients,based on the related factors which we discussed above,that we may gain the better clinical benefits.It show that targeted therapy, metachronous gastrointestinal stromal tumor,the site of liver metastases tumor accepted R0 surgical resection and targeted therapy in combined with surgical treatment were independentfactors affecting the prognosis by multiple factors analysis.So we should pay more attention to the several factors especially in clinic.But it’s a pity that the number of sample size was less and we did not analyze the complications,and we did not calculate the period of diease-free survival and stable survival of patient because of the incomplete date.It would be improved in the future.According to the above we discussed.GIST metastatic to liver is still given priority to with surgical treatment combined with targeted therapy,andin combined with targeted therapy, R0 surgical resection for primary and liver metastic tumors would improve the prognosis.It will provide some reference for our clinical treatment in the future.