Long-Term Prognosis Analysis of Gastrointestinal Stromal Tumors in the Jejunum and Ileum: A SEER-Based Study

空肠和回肠胃肠道间质瘤的长期预后分析:一项基于SEER数据库的研究

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Abstract

IntroductionThe prognosis differences of gastrointestinal stromal tumors (GISTs) between the jejunum and ileum have rarely been studied. This study aimed to evaluate the long-term survival outcomes in patients with jejunal and ileal GISTs.MethodsThis population-based retrospective cohort study utilized data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019. Kaplan-Meier analyses and Cox proportional hazards models were employed to assess overall survival (OS) and cancer-specific survival (CSS). A 1:1 propensity score matching (PSM) approach was implemented to address confounding factors, and subgroup analyses were performed for various variables.ResultsA total of 1237 patients were analyzed, with 848 in the jejunum and 389 in the ileum. Ileal GISTs patients were older, exhibited higher T stages, larger tumor sizes, elevated mitotic rates, and were more susceptible to distant metastasis (P<0.05). After PSM, the jejunal GISTs group and the ileal GISTs group demonstrated comparable OS (hazard ratio [HR]: 1.25, 95% confidence interval [CI]: 0.97-1.60, P=0.082) and CSS (HR: 1.13, 95% CI: 0.81-1.59, P=0.461). Additionally, jejunal GISTs and ileal GISTs exhibited similar OS and CSS across various subgroups. Multivariate Cox regression analysis revealed age, TNM stage, and mitotic rate as independent risk factors influencing OS, whereas race, N stage, and M stage were identified as independent risk factors affecting CSS.ConclusionsJejunal GISTs and ileal GISTs have comparable OS and CSS, with the occurrence of lymph node metastasis and distant metastasis being important factors affecting their prognosis.

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