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Martin-Broto J, Gutierrez A, Garcia-Del-Muro X, Lopez-Guerrero JA, Martinez-Trufero J, de Sande LM, Lainez N, Maurel J, De Juan A, Losa F, Andres R, Casado A, Tejido PG, Blanco R, Carles J, Bellmunt J, Gomez-España A, Ramos R, Martinez-Serra J, Llombart-Bosch A, Poveda A. Prognostic time dependence of deletions affecting codons 557 and/or 558 of KIT gene for relapse-free survival (RFS) in localized GIST: a Spanish Group for Sarcoma Research (GEIS) Study. Ann Oncol 2010; 21:1552-1557. [PMID: 20231303 DOI: 10.1093/annonc/mdq047] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To assess whether deletions involving codons 557 and/or 558 (critical deletions) of exon 11 of KIT are relevant in the prognosis of relapse-free survival (RFS) in gastrointestinal stromal tumor (GIST) patients with a long follow-up. PATIENTS AND METHODS A univariate and multivariate analysis for RFS were carried out on 162 localized GIST patients over the entire follow-up period and over the intervals 0-4 years and >4 years. Factors assessed among others were Fletcher/National Institutes of Health and Miettinen-Lasota/Armed Forces Institute of Pathology (M-L/AFIP) risk categories, critical deletions and non-deletion-type mutation (NDTM) within exon 11 of KIT. RESULTS Multivariate analyses revealed that M-L/AFIP [relative risk (RR) 11.45, confidence interval (CI) 4.40-29.76, for the high-risk subgroup and RR 5.97, CI 2.09-17.06, for the intermediate subgroup] and critical deletions (RR 3.05, CI 1.59-5.85) were independent prognostic factors for RFS for the first 4 years and for the entire follow-up period. Beyond 4 years, the high-risk M-L/AFIP subgroup (RR 8.12, CI 1.48-44.4) and NDTM (RR 6.42, CI 1.17-35.12) were independent prognostic factors for RFS. The median follow-up was 84 months. CONCLUSION Critical deletions represent a time-dependent prognostic factor limited to the first 4 years after surgery, which could help identify a subset with higher and earlier risk for relapse in GIST patients.
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Affiliation(s)
- J Martin-Broto
- Departments of Oncology and Hematology, Medical and Translational Hemato-Oncology Group, Hospital Universitario Son Dureta, Palma de Mallorca.
| | - A Gutierrez
- Departments of Oncology and Hematology, Medical and Translational Hemato-Oncology Group, Hospital Universitario Son Dureta, Palma de Mallorca
| | | | - J A Lopez-Guerrero
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, Valencia
| | | | - L M de Sande
- Department of Oncology, Complejo Hospitalario de León, Leon
| | - N Lainez
- Department of Oncology, Hospital Virgen del Camino, Pamplona
| | - J Maurel
- Department of Oncology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica de Enfermedades Hepáticas y Digestivas, Barcelona
| | - A De Juan
- Oncology Department, Hospital de Valdecilla, Santander
| | - F Losa
- Department of Oncology, Hospital General, Hospitalet de Llobregat
| | - R Andres
- Department of Oncology, Hospital Clínico Lozano Blesa, Zaragoza
| | - A Casado
- Department of Oncology, Hospital Universitario San Carlos, Madrid
| | - P G Tejido
- Department of Oncology, Hospital San Pedro, Logroño
| | - R Blanco
- Department of Oncology, Hospital Mutua de Terrassa, Terrassa
| | - J Carles
- Department of Oncology, Hospital del Mar, Barcelona
| | - J Bellmunt
- Department of Oncology, Hospital Vall d'Hebron, Barcelona
| | | | - R Ramos
- Department of Pathology, Hospital Universitario Son Dureta, Palma de Mallorca
| | - J Martinez-Serra
- Laboratory of Molecular Biology, Hospital Universitario Son Dureta, Palma de Mallorca
| | | | - A Poveda
- Department of Oncology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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