Editing GIST (section)

== Prognosis ==

* Prognosticating calculators:
** AFIP model - most      commonly-used. Classify as no, low, intermediate or high risk.
** NIH/Fletcher critera -      incorporates tumour rupture
* Median survival >5 years     even in metastatic disease



'''AFIP prognostic model: Recurrence risk for gastrointestinal stromal tumors (GISTs) of the stomach, small intestine, and rectum by mitotic rate and tumor size'''
{| class="wikitable"
|'''Tumor size (cm)'''
|'''Risk of disease progression during long-term  follow-up by primary site'''
|
|
|
|-
|
|'''Gastric'''
|'''Jejunum/ileum*'''
|'''Duodenum'''
|'''Rectum'''
|-
|'''Mitotic rate¶ (HPF): ≤5/50'''
|
|
|
|
|-
|≤2
|No risk
|No risk
|No risk
|No risk
|-
|2 to 5
|Very low
|Low
|Low
|Low
|-
|5 to 10
|Low
|Intermediate
|Limited data
|Limited data
|-
|>10
|Intermediate
|High
|High
|High
|-
|'''Mitotic rate¶ (HPF): >5/50'''
|
|
|
|
|-
|≤2
|No riskΔ
|HighΔ
|Limited data
|High
|-
|2 to 5
|Intermediate
|High
|High
|High
|-
|>5
|High
|High
|High◊
|High◊
|}


'''AFIP prognostic model: progression-free survival for gastrointestinal stromal tumors (GISTs) of the stomach, small intestine, and rectum by mitotic rate and tumor size*'''
{| class="wikitable"
|'''Tumor size'''

'''(cm)'''
|'''Percent of patients progression free during  long-term follow-up by primary site'''
|
|
|
|-
|
|'''Gastric'''
|'''Jejunum/ileum'''
|'''Duodenum'''
|'''Rectum'''
|-
|'''Mitotic rate¶ (HPF): ≤5/50'''
|
|
|
|
|-
|≤2
|100
|100
|100
|100
|-
|2 to 5
|98.1
|95.7
|91.7
|91.5
|-
|5 to 10
|96.4
|76
|66*
|43*
|-
|>10
|88
|48
|
|
|-
|'''Mitotic rate¶ (HPF): >5/50'''
|
|
|
|
|-
|≤2
|100Δ
|50Δ
|–
|46
|-
|2 to 5
|84
|27
|50
|48
|-
|5 to 10
|45
|15
|14*
|29*
|-
|>10
|14
|10
|
|
|}


'''Modified NIH risk stratification criteria for GIST with rupture included'''
{| class="wikitable"
|'''Risk category'''
|'''Tumor size (cm)'''
|'''Mitotic index (per 50 HPFs)'''
|'''Primary tumor site'''
|-
|Very low risk
|<2.0
|≤5
|Any
|-
|Low risk
|2.1 to 5.0
|≤5
|Any
|-
|Intermediate risk
|2.1 to 5.0
|>5
|Gastric
|-
|
|<5.0
|6 to 10
|Any
|-
|
|5.1 to 10.0
|≤5
|Gastric
|-
|High risk
|Any
|Any
|Tumor rupture
|-
|
|>10 cm
|Any
|Any
|-
|
|Any
|>10
|Any
|-
|
|>5.0
|>5
|Any
|-
|
|2.1 to 5.0
|>5
|Nongastric
|-
|
|5.1 to 10.0
|≤5
|Nongastric
|}
[[Category:UGIS]]