J Korean Surg Soc.  2012 Aug;83(2):83-87. 10.4174/jkss.2012.83.2.83.

Preoperative predictors of malignant gastric submucosal tumor

• Kim HG
• Ryu SY
• Yun SK
• Joo JK
• Lee JH
• Kim DY

• KMID: 1820091
• DOI: http://doi.org/10.4174/jkss.2012.83.2.83

Abstract

PURPOSE
The preoperative prediction of malignant potential in patients with gastric submucosal tumors (SMTs) plays an important role in decisions regarding their surgical management.
METHODS
We evaluated the predictors of malignant gastric SMTs in 314 patients with gastric SMTs who underwent surgery in Chonnam National University Hospital.
RESULTS
The malignant SMTs were significantly associated with age (odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042 to 1.091; P < 0.0001), presence of central ulceration (OR, 2.690; 95% CI, 1.224 to 5.909; P = 0.014), and tumor size (OR, 1.791; 95% CI, 1.483 to 2.164; P < 0.0001). Receiver operating characteristic curve analysis showed that tumor size was a good predictor of malignant potential. The most relevant predictor of malignant gastric SMT was tumor size with cut-offs of 4.05 and 6.40 cm.
CONCLUSION
Our findings indicated that age, central ulceration, and tumor size were significant preoperative predictors of malignant SMTs. We suggest that 4 cm be selected as a threshold value for malignant gastric SMTs. In patients with a gastric SMT larger than 4 cm with ulceration, wide resection of the full thickness of the gastric wall or gastrectomy with adequate margins should be performed because of its malignant potential.

Keyword

Stomach neoplasms; Submucosal tumor; Malignant factor; Preoperative predictor

MeSH Terms

Gastrectomy
Humans
ROC Curve
Stomach Neoplasms
Ulcer

Figure

• 

  Fig. 1 The receiver operating characteristic curve of tumor size for predicting malignant gastric submucosal tumors.

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