Limits...
Impact of age and gender on tumor related prognosis in gastrointestinal stromal tumors (GIST).

Kramer K, Knippschild U, Mayer B, Bögelspacher K, Spatz H, Henne-Bruns D, Agaimy A, Schwab M, Schmieder M - BMC Cancer (2015)

Bottom Line: DSS was significantly more favorable in younger female GIST patients compared with elderly females (p = 0.008).Female gender resulted again in better prognosis in younger patients (p = 0.033).Extended studies are warranted to confirm our clinical results and to elucidate underlying pathophysiological mechanisms.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. klaus.kramer@uniklinik-ulm.de.

ABSTRACT

Background: Risk classification and prediction of prognosis in GIST is still a matter of debate. Data on the impact of age and gender as potential confounding factors are limited. Therefore we comprehensively investigated age and gender as independent risk factors for GIST.

Methods: Two independent patient cohorts (cohort I, n = 87 [<50 years]; cohort II, n = 125 [≥50 years]) were extracted from the multicentre Ulmer GIST registry including a total of 659 GIST patients retrospectively collected in 18 collaborative German oncological centers. Based on demographic and clinicopathological parameters and a median follow-up time of 4.3 years (range 0.56; 21.33) disease-specific-survival (DSS), disease-free-survival (DFS) and overall survival (OS) were calculated.

Results: GIST patients older than fifty years showed significantly worse DSS compared to younger patients (p = 0.021; HR = 0.307, 95% CI [0.113; 0.834]). DSS was significantly more favorable in younger female GIST patients compared with elderly females (p = 0.008). Female gender resulted again in better prognosis in younger patients (p = 0.033).

Conclusions: Patient age (<50 years) and female gender were significantly associated with a more favourable prognosis in GIST. Extended studies are warranted to confirm our clinical results and to elucidate underlying pathophysiological mechanisms.

Show MeSH

Related in: MedlinePlus

Kaplan–Meier curves of disease-specific survival (DSS) for GIST patients of study cohort I (<50 years at diagnosis, n = 87)versusstudy cohort II (≥50 years at diagnosis, n = 125).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4384379&req=5

Fig2: Kaplan–Meier curves of disease-specific survival (DSS) for GIST patients of study cohort I (<50 years at diagnosis, n = 87)versusstudy cohort II (≥50 years at diagnosis, n = 125).

Mentions: At date of diagnosis the rate of metastasis was not different between sub-cohort I (10.3%) and sub-cohort II (12.8%; p = 0.586, Table 1). The outcome of GIST patients was generally more favourable in young patients (cohort I) vs. older patients (cohort II). DSS rates after 1-, 3- and 5-year follow-up in “young” vs. “old” patients were 98.5% vs. 96.2%, 96.6% vs. 87.0% and 96.6% vs. 81.2%, respectively. After 5-year follow up DSS was significantly better in GIST patients younger than 50 years (p = 0.015, log-rank-test; Figure 2). A multivariate Cox regression model adjusted for gender and tumor localization confirmed improved outcome for younger patients (p = 0.036, HR = 0.27, 95% CI: 0.079, 0.921). Moreover, we elucidated whether age as a continuous variable is an independent prognostic factor. Again we could show that the older age was associated with an increased risk for DSS (p = 0.002, HR = 1.049, 95% CI: 1.018, 1.080) and OS (p < 0.0001; HR = 1.051, 95% CI: 1.029, 1.074).Figure 2


Impact of age and gender on tumor related prognosis in gastrointestinal stromal tumors (GIST).

Kramer K, Knippschild U, Mayer B, Bögelspacher K, Spatz H, Henne-Bruns D, Agaimy A, Schwab M, Schmieder M - BMC Cancer (2015)

Kaplan–Meier curves of disease-specific survival (DSS) for GIST patients of study cohort I (<50 years at diagnosis, n = 87)versusstudy cohort II (≥50 years at diagnosis, n = 125).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4384379&req=5

Fig2: Kaplan–Meier curves of disease-specific survival (DSS) for GIST patients of study cohort I (<50 years at diagnosis, n = 87)versusstudy cohort II (≥50 years at diagnosis, n = 125).
Mentions: At date of diagnosis the rate of metastasis was not different between sub-cohort I (10.3%) and sub-cohort II (12.8%; p = 0.586, Table 1). The outcome of GIST patients was generally more favourable in young patients (cohort I) vs. older patients (cohort II). DSS rates after 1-, 3- and 5-year follow-up in “young” vs. “old” patients were 98.5% vs. 96.2%, 96.6% vs. 87.0% and 96.6% vs. 81.2%, respectively. After 5-year follow up DSS was significantly better in GIST patients younger than 50 years (p = 0.015, log-rank-test; Figure 2). A multivariate Cox regression model adjusted for gender and tumor localization confirmed improved outcome for younger patients (p = 0.036, HR = 0.27, 95% CI: 0.079, 0.921). Moreover, we elucidated whether age as a continuous variable is an independent prognostic factor. Again we could show that the older age was associated with an increased risk for DSS (p = 0.002, HR = 1.049, 95% CI: 1.018, 1.080) and OS (p < 0.0001; HR = 1.051, 95% CI: 1.029, 1.074).Figure 2

Bottom Line: DSS was significantly more favorable in younger female GIST patients compared with elderly females (p = 0.008).Female gender resulted again in better prognosis in younger patients (p = 0.033).Extended studies are warranted to confirm our clinical results and to elucidate underlying pathophysiological mechanisms.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. klaus.kramer@uniklinik-ulm.de.

ABSTRACT

Background: Risk classification and prediction of prognosis in GIST is still a matter of debate. Data on the impact of age and gender as potential confounding factors are limited. Therefore we comprehensively investigated age and gender as independent risk factors for GIST.

Methods: Two independent patient cohorts (cohort I, n = 87 [<50 years]; cohort II, n = 125 [≥50 years]) were extracted from the multicentre Ulmer GIST registry including a total of 659 GIST patients retrospectively collected in 18 collaborative German oncological centers. Based on demographic and clinicopathological parameters and a median follow-up time of 4.3 years (range 0.56; 21.33) disease-specific-survival (DSS), disease-free-survival (DFS) and overall survival (OS) were calculated.

Results: GIST patients older than fifty years showed significantly worse DSS compared to younger patients (p = 0.021; HR = 0.307, 95% CI [0.113; 0.834]). DSS was significantly more favorable in younger female GIST patients compared with elderly females (p = 0.008). Female gender resulted again in better prognosis in younger patients (p = 0.033).

Conclusions: Patient age (<50 years) and female gender were significantly associated with a more favourable prognosis in GIST. Extended studies are warranted to confirm our clinical results and to elucidate underlying pathophysiological mechanisms.

Show MeSH
Related in: MedlinePlus