Dataset Information

Adherence to the guidelines and the pathological diagnosis of high-risk gastrointestinal stromal tumors in the real world.

ABSTRACT:

Background

A multidisciplinary approach based on guidelines and pathological diagnosis by specialized pathologists are important for improving the prognosis and QoL of GIST patients. This study examined the adherence to the guidelines and the concordance of the pathological diagnosis of high-risk GISTs.

Patients and methods

Among 541 patients with high-risk GISTs recruited to the prospective registry between Dec. 2012 and Dec. 2015, 534 patients were analyzed after central pathology with KIT and DOG1 IHC and genotyping of KIT and PDGFRA.

Results

Of the 534 patients, 432 (81%) received imatinib adjuvant therapy at a starting dose of 400 or 300 mg/day. Multivariate analysis indicated that age (HR 0.71; 95% CI 0.58-0.88), tumor size (HR for?>?10 cm vs??10 vs?ConclusionsThe adherence to guidelines and the concordance of pathological diagnoses were comparatively good for high-risk GISTs. Central pathology may contribute to improved diagnosis, but further refinements may be required.

SUBMITTER: Nishida T

PROVIDER: S-EPMC6942594 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Adherence to the guidelines and the pathological diagnosis of high-risk gastrointestinal stromal tumors in the real world.

Nishida Toshirou T Sakai Yoshiharu Y Takagi Masakazu M Ozaka Masato M Kitagawa Yuko Y Kurokawa Yukinori Y Masuzawa Toru T Naito Yoichi Y Kagimura Tatsuo T Hirota Seiichi S

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 20190430 1

<h4>Background</h4>A multidisciplinary approach based on guidelines and pathological diagnosis by specialized pathologists are important for improving the prognosis and QoL of GIST patients. This study examined the adherence to the guidelines and the concordance of the pathological diagnosis of high-risk GISTs.<h4>Patients and methods</h4>Among 541 patients with high-risk GISTs recruited to the prospective registry between Dec. 2012 and Dec. 2015, 534 patients were analyzed after central patholo ...[more]

PMID: 31041650

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Project description:ObjectiveImmune checkpoint inhibitors(ICIs) have improved survival and are increasingly used for cancer. However, ICIs use may be limited by immune-related adverse events (irAEs), such as ICI-induced diabetes mellitus(ICI-DM). The objective of the present study was to characterize ICI-DM patients and real-world adherence to guidelines.Research design and methodsThe present study was a retrospective review of electronic records of ICI-DM patients at the First Affiliated Hospital of Nanjing Medical University between July 2018 and October 2022.Results34.8% (8/23)patients monitored blood glucose in every treatment cycle. The proportion of patients with severe diabetic ketoacidosis(DKA) was lower in the tight glycemic monitoring group than the non-tight glycemic monitoring group (16.7% vs. 55.6%, p = 0.049). 78.3%(18/23) patients with hyperglycemia visited a non-endocrinologist first, but 95.7% of patients were then referred to an endocrinologist. Twenty patients were tested for distinguishing the etiology of hyperglycemia and 20% patients with positive glutamic acid decarboxylase antibody(GADA), 55% with C-peptide <3.33pmol/L. High screening rates for other ICI-induced endocrinopathies were observed and half of the patients with ICI-DM developed other endocrine gland irAEs, with the most common being thyroiditis. Moreover, five patients developed non-endocrine serious adverse events(SAEs). Twelve (52.2%) patients were withdrawn from ICI due to ICI-DM. The time to progression of tumor in ICI-DM patients in the continue and interruption group was longer than in the withdrawal group (333.5 ± 82.5 days vs. 183.1 ± 62.4 days, p = 0.161). Only 17.4% of ICI-DM patients were completely managed according to guidelines. Thus, the present study proposed a screening, diagnosis, and management algorithm for ICI-DM in real-world practice.ConclusionThe present study reported the largest number of ICI-DM cases described in a single institute, providing insight into real-world ICI-DM management guideline adherence and highlighting the clinical challenges in ICI-DM management.

Dataset Information

Adherence to the guidelines and the pathological diagnosis of high-risk gastrointestinal stromal tumors in the real world.

Background

Patients and methods

Results

Publications

Adherence to the guidelines and the pathological diagnosis of high-risk gastrointestinal stromal tumors in the real world.

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