Table 1.
The clinicopathological characteristics, surgical data of IM neoadjuvant therapy and direct surgery for all 101 rectal GIST patients
| Variables | IM neoadjuvant therapy (N = 31) | Direct surgery (N = 70) | Number (N = 101) (N/%) |
|---|---|---|---|
| Agea (years) | |||
| ≤ 60 | 17 | 45 | 62 (61.4) |
| > 60 | 14 | 25 | 39 (38.6) |
| Sex | |||
| Male | 17 | 47 | 64 (63.4) |
| Female | 14 | 23 | 37 (36.6) |
| Different era | |||
| 2002–2011 | 0 | 22 | 22 (21.8) |
| 2012–2020 | 31 | 48 | 79 (78.2) |
| ECOG performance score | |||
| 0 | 29 | 62 | 91 (90.1) |
| 1 | 2 | 8 | 10 (9.9) |
| Initial clinical manifestation | |||
| Rectal bleeding | 10 | 10 | 20 (19.8) |
| Change in bowel of stool | 4 | 11 | 15 (14.9) |
| Change in bowel habit | 5 | 13 | 18 (17.8) |
| Rectal discomfort | 5 | 12 | 17 (16.8) |
| Digital rectal examinationb | 3 | 15 | 18 (17.8) |
| Others | 4 | 9 | 13 (12.9) |
| Tumor sizec (cm) | |||
| ≤ 5 | 2 | 34 | 36 (35.6) |
| > 5 | 29 | 36 | 65 (64.4) |
| Approach of surgery | |||
| Laparotomy | 25 | 57 | 82 (81.2) |
| Laparoscopy | 6 | 8 | 14 (13.9) |
| Endoscopy | 0 | 5 | 5 (4.9) |
| Type of surgery | |||
| Local | 30 | 65 | 95 (94.1) |
| Radical | 1 | 5 | 6 (5.9) |
| Procedure of surgeryd | |||
| LAR | 27 | 43 | 70 (69.3) |
| ISR | 2 | 7 | 9 (9.0) |
| APR | 2 | 15 | 17 (16.8) |
| LR | 0 | 5 | 5 (4.9) |
| Covering stoma in sphincter-preserving surgery (LAR + ISR)e | |||
| Yes | 3 | 10 | 13 (16.5) |
| No | 26 | 40 | 66 (83.5) |
| Surgical margin | |||
| Positive | 0 | 4 | 4 (4.0) |
| Negative | 31 | 66 | 97 (96.0) |
| Tumor rupture | |||
| Yes | 0 | 0 | 0 (0.0) |
| No | 31 | 70 | 101 (100.0) |
| Postoperative complications | |||
| Rectal bleeding | 0 | 1 | 1 (1.0) |
| Anastomotic fistula | 1 | 4 | 5 (4.9) |
| Wound infection | 2 | 4 | 6 (5.9) |
| Abdominal infection | 1 | 2 | 3 (3.0) |
| Others | 1 | 4 | 5 (4.9) |
| None | 26 | 55 | 81 (80.3) |
| Mitotic index (50HPF) | |||
| ≤ 5 | 22 | 28 | 50 (49.5) |
| > 5 | 9 | 42 | 51 (50.5) |
| Pathological feature | |||
| Spindle | 28 | 54 | 82 (81.2) |
| Epithelial | 2 | 13 | 15 (14.9) |
| Mixed | 1 | 3 | 4 (3.9) |
| Immunohistochemistry | |||
| CD117 positive | 29 | 69 | 98 (97.0) |
| DOG-1positivef | 29 | 46 | 75 (96.2) |
| CD34 positive | 28 | 55 | 83 (82.1) |
| Modified NIH criteriag | |||
| Very low risk | – | 8 | 8 (11.4) |
| Low risk | – | 10 | 10 (14.3) |
| Intermediate risk | – | 7 | 7 (10.0) |
| High risk | – | 45 | 45 (64.3) |
| Genetic mutationh | |||
| KIT Exon 11 mutation | 14 | 25 | 39 (83.0) |
| KIT Exon 9 mutation | 2 | 2 | 4 (8.5) |
| Wild type mutation | 1 | 3 | 4 (8.5) |
| Postoperative IM adjuvant treatment | |||
| Yes | 25 | 24 | 49 (48.5) |
| No | 6 | 46 | 52 (51.5) |
aAge: 22–79 years (55.4 ± 12.2 years)
b17.8% of the patients were found initially during the rectal palpation, and a total of 69.3% (70/101) of all the patients could be found by this examination
cThe median size was 6.18 ± 3.02 cm
dLAR: Low anterior resection; ISR: Intersphincteric resection; APR: Abdominoperineal resection; LR: local resection [8]
eA total of 79 patients had sphincter-preserving surgery (LAR + ISR)
fOnly 78 patients underwent DOG-1 testing
gExcluding 31 neoadjuvant patients who were not applicable to modified NIH criteria,70 patients left
hOnly 47 patients underwent genetic testing