Association of recurrence with patient and tumor factors in gastrointestinal stromal tumors of small intestine: A single‑institutional retrospective study

Gastrointestinal stromal tumors (GISTs) are relatively rare, with 35% of GISTs occurring in the small intestine. The recurrence rate of small intestinal GISTs is higher than that of gastric GISTs. The present study aimed to identify the factors involved in the recurrence of small intestinal GISTs using data obtained from patients treated at Chiba University Graduate School of Medicine (Chuo, Japan). Overall, 27 lesions in 26 patients who underwent radical resection for small intestinal GISTs at Chiba University Hospital between January 2002 and December 2021 were retrospectively analyzed to determine the association between clinicopathological factors and recurrence. Recurrence occurred in 9 out of the 26 patients. A univariate nominal logistic analysis revealed that jejunal lesions, tumor size ≥60 mm, maximum standardized uptake value ≥8.4, mitotic count ≥4/50 high power field, Ki-67 index ≥10%, neutrophil-to-lymphocyte ratio (NLR) ≥3.7, platelet-to-lymphocyte ratio ≥227 and Onodera's prognostic nutritional index ≤51 were significantly associated with postoperative recurrence. The NLR was moderately correlated with tumor size and Ki-67 index. This study has revealed that patient and tumor factors are associated with the recurrence of small intestinal GISTs. Elucidating the fundamental mechanisms linking inflammatory and nutritional indicators to tumor recurrence may provide novel insights into the progression and treatment strategies required for small intestinal GISTs.