{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:31:59Z","timestamp":1740130319191,"version":"3.37.3"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A gastrointestinal stromal tumor rupture entails a high risk of recurrence even after curative surgery. However, the definition of rupture is unclear, and the question of whether patients with a minor rupture should be treated with adjuvant imatinib remains controversial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The present, retrospective, multicentric study enrolled 57 patients with gastrointestinal stromal tumor with a minor\/major tumor rupture, of whom 46 were finally found to be eligible for analysis. Tumor ruptures were subclassified by their degree, timing and cause. Multivariate analysis was performed to identify the risk factors of all types of recurrence as well as of peritoneal recurrence only.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study cohort included minor (n\u00a0=\u00a024), intraoperative (n\u00a0=\u00a019) and iatrogenic (n\u00a0=\u00a020) ruptures besides the typical types (major, preoperative and spontaneous). All intraoperative ruptures were iatrogenic. In total, 27 patients (58.7%) had a recurrence in the peritoneum (n\u00a0=\u00a017) and\/or the liver (n\u00a0=\u00a013) during a median follow-up period of 5.8\u00a0years, but no recurrence was observed in patients with tumor rupture as a single, high-risk factor. Multivariate analysis found the timing of tumor rupture to be an independent risk factor of poor recurrence-free survival (hazard ratio: 2.37; 95% confidence interval: 1.02\u20135.49; P\u00a0=\u00a00.045).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Preoperative tumor rupture in patients with a ruptured gastrointestinal stromal tumor was associated with poor recurrence-free survival. Our results suggested that a distinction should be made between preoperative and intraoperative tumor ruptures when considering the indications for adjuvant imatinib therapy for gastrointestinal stromal tumor patients with tumor rupture as a single, high-risk factor of recurrence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyab200","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T22:31:51Z","timestamp":1638311511000},"page":"237-243","source":"Crossref","is-referenced-by-count":3,"title":["Impact of preoperative tumor rupture timing on gastrointestinal stromal tumor prognosis: a retrospective multicentric cohort study"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-8156","authenticated-orcid":false,"given":"Gaku","family":"Chiguchi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Japan Labour Health and Welfare Organization, Yokohama Rosai Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6450-1272","authenticated-orcid":false,"given":"Haruhiko","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan"},{"name":"Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhito","family":"Nabeshima","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tokai University, Isehara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsunehiko","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hitachi General Hospital, Hitachi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikinori","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sou","family":"Katayanagi","sequence":"additional","affiliation":[{"name":"Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotoshi","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"2022030408310955800_ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S1470-2045(11)70299-6","article-title":"Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts","volume":"13","author":"Joensuu","year":"2012","journal-title":"Lancet Oncol"},{"key":"2022030408310955800_ref2","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1200\/JCO.2007.13.4403","article-title":"Long-term results from a randomized phase II trial of standard- versus higher-dose imatinib mesylate for patients with unresectable or metastatic gastrointestinal 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intestine","volume":"103","author":"H\u00f8lmebakk","year":"2016","journal-title":"Br J Surg"},{"key":"2022030408310955800_ref12","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1245\/s10434-019-07297-9","article-title":"Defining tumor rupture in gastrointestinal stromal tumor","volume":"26","author":"Nishida","year":"2019","journal-title":"Ann Surg Oncol"}],"container-title":["Japanese Journal of Clinical 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