{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T11:43:34Z","timestamp":1763120614497,"version":"3.45.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81702386","81874184","82072736"],"award-info":[{"award-number":["81702386","81874184","82072736"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The clinicopathological features and outcome of gastrointestinal stromal tumors (GISTs) with lymph node metastasis remain controversial owing to their low incidence. A multicenter retrospective cohort study was conducted to compare the clinicopathological features and oncologic outcomes of GIST without metastasis, with lymph node metastasis, and with distant metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The medical records of patients with GISTs in 16 large medical centers in China from January 2014 to December 2022 were reviewed. Patients were divided into four groups: no metastasis (988 cases, 89.1%), lymph node metastasis without distant metastasis (75 cases, 6.8%), distant metastasis without lymph node metastasis (36 cases, 3.2%), and distant metastasis with lymph node metastasis group (10 cases, 0.9%). Propensity score matching (PSM) was performed to reduce confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>A total of 1109 cases of primary GIST were included in this study, comprising 607 males (54.7%) and 502 females (45.3%), with a mean age of 56.6\u2009\u00b1\u200911.9\u2009years. Compared to that in GIST without lymph node metastasis, the proportion of nongastric GIST was higher in GIST with lymph node metastasis (52.9% vs 40.7%) with a larger tumor diameter (&amp;gt;10\u2009cm: 36.5% vs 18.1%) and more patients with distant metastasis (11.8% vs 3.5%). Tumor location not in the stomach, the largest tumor diameter, and distant metastasis were independent risk factors for GIST with lymph node metastasis (all P\u2009&amp;lt;\u2009.05). After PSM, 96, 48, 24 patients comprised no metastasis, lymph node metastasis without distant metastasis, and distant metastasis without lymph node metastasis, respectively. The relapse-free survival (RFS) of the lymph node metastasis group was comparable to that of the distant metastasis group without lymph node metastasis (P\u2009=\u2009.368) and significantly inferior to that of no metastases (P\u2009=\u2009.042).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The RFS of patients with GIST with lymph node metastasis was comparable to those with distant metastasis and significantly worse than those without metastasis. Lymph node metastasis is an advanced event in GIST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf351","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:22:06Z","timestamp":1760617326000},"source":"Crossref","is-referenced-by-count":0,"title":["Is lymph node metastasis an advanced event of gastrointestinal stromal tumor?"],"prefix":"10.1093","volume":"30","author":[{"given":"Qi","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430022,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430022,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weili","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310003,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Zhongshan Hospital, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingfeng","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Taihe Hospital of Hubei University of Medicine , Shiyan 442000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University , Chongqing 400016,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu 610041,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Feng","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Air Force Medical University , Xi\u2019an 710032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanxi Province Cancer Hospital (Shanxi Cancer institute) , Taiyuan 030013,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University , Zhengzhou, 450052,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of General Surgical Medicine, The First Medicine Center of PLA General Hospital , Beijing 100853,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3155-7114","authenticated-orcid":false,"given":"Xinhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Wu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Colorectal Surgery, Sun Yat-sen University Cancer Center , Guangzhou 510060,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8415-7587","authenticated-orcid":false,"given":"Zhidong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Peking University People\u2019s Hospital, Peking University , Beijing 100044,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Gastric Cancer Center, Tianjin Medical University, Cancer Institute & Hospital , Tianjin 300060,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3683-1565","authenticated-orcid":false,"given":"Yanbing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University , Qingdao 266003,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heli","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University , Changsha, Hunan 410008,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7723-6121","authenticated-orcid":false,"given":"Kaixiong","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 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