# Gastrointestinal Bleeding in Small Intestinal Stromal Tumors: A Clinicopathological and Survival Analysis

## TL;DR

This study finds that gastrointestinal bleeding in small intestinal stromal tumors is linked to worse outcomes and identifies key factors affecting prognosis.

## Contribution

The study identifies GI bleeding as an independent predictor of prognosis in SISTs, particularly in high-risk patients.

## Key findings

- GI bleeding is associated with tumor rupture and higher Ki-67 positivity in SIST patients.
- GI bleeding significantly impacts relapse-free survival in high-risk SIST patients.
- Mitotic count, tumor rupture, Ki-67 abundance, and GI bleeding are independent predictors of SIST prognosis.

## Abstract

This study analyzes the clinical pathological characteristics and prognostic factors of small intestinal stromal tumor (SIST) patients with gastrointestinal (GI) bleeding and investigates whether GI bleeding is an independent predictor of SIST prognosis.

A retrospective analysis of 152 patients diagnosed with SISTs at Zhangzhou Municipal Hospital Affiliated to Fujian Medical University was conducted. Patients were divided into 2 groups based on the presence or absence of GI bleeding. Both survival and recurrence rates were calculated using univariate survival analysis and Cox regression analysis, respectively.

Compared with the non-GI bleeding group, the GI bleeding group showed significant differences in tumor rupture and Ki-67 abundance (P < .05). Survival analysis revealed that patients with GI bleeding had a shorter relapse-free survival (RFS) compared to those without GI bleeding (P = .016); however, GI bleeding significantly impacted RFS only in the high-risk group (P = .001). Cox regression analysis showed that mitotic count (P = .021), tumor rupture (P = .032), Ki67 positivity (P = .032), and GI bleeding (P = .04) were independent factors affecting the relapse-free survival rate of SISTs.

This study shows that SIST patients with GI bleeding are more likely to experience tumor rupture and have higher Ki-67 positivity than those without GI bleeding. Mitotic count, tumor rupture, Ki-67 abundance, and GI bleeding are independent predictors of SIST prognosis. Additionally, the RFS rate for patients with GI bleeding is shorter, particularly among high-risk patients.