Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study

BackgroundIn 2009, the American Joint Commission on Cancer incorporated the gastrointestinal stromal tumours (GISTs) risk classification into the tumour, node, metastasis (TNM) staging system. We aimed to evaluate the prognostic value of the TNM staging system for GISTs by directly comparing it with...

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Main Authors: Jin-hu Chen, Zhen-rong Yang, Zhi-ming Cai, Tao Lin, Ren Lin, Xin-cheng Su, Rong-bin Kang, Lu Lin, Zai-sheng Ye, Yong-jian Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1622777/full
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author Jin-hu Chen
Zhen-rong Yang
Zhi-ming Cai
Tao Lin
Ren Lin
Xin-cheng Su
Rong-bin Kang
Lu Lin
Zai-sheng Ye
Yong-jian Zhou
author_facet Jin-hu Chen
Zhen-rong Yang
Zhi-ming Cai
Tao Lin
Ren Lin
Xin-cheng Su
Rong-bin Kang
Lu Lin
Zai-sheng Ye
Yong-jian Zhou
author_sort Jin-hu Chen
collection DOAJ
description BackgroundIn 2009, the American Joint Commission on Cancer incorporated the gastrointestinal stromal tumours (GISTs) risk classification into the tumour, node, metastasis (TNM) staging system. We aimed to evaluate the prognostic value of the TNM staging system for GISTs by directly comparing it with the modified National Institutes of Health (NIH) criteria.Materials and methodsWe /used data from the Surveillance, Epidemiology, and End Results (SEER) database (2010–2019) to retrospectively analyse patients with gastric and small intestinal/colorectal GISTs. Multivariate Cox regression analysis was performed to identify independent prognostic factors for cancer-specific survival (CSS). To assess the predictive performance of the TNM staging system and the modified NIH criteria, we calculated the area under the receiver operating characteristic curve (AUC), concordance index (C-index), Akaike information criterion (AIC), and Bayesian information criterion (BIC).ResultsOf the 3,034 patients included, 2,106 had gastric GISTs and 928 had small intestinal/colorectal GISTs. Multivariate Cox analysis revealed that TNM stage was an independent prognostic factor for CSS. According to the modified NIH criteria, both the overall and subgroup cohorts exhibited better CSS in the low-risk group than that in the very low-risk group. In contrast, for the TNM staging system, the difference in CSS between stages IIIA and IIIB were not statistically significant (all P>0.05). Notably, only 2 of the 928 patients with small intestinal/colorectal GISTs met the modified NIH criteria for intermediate risk. In the gastric GISTs cohort, the AUC, C-index, AIC, and BIC values for the TNM staging system and the modified NIH criteria were similar. However, in the small intestine and colorectal GISTs cohort, the TNM staging system demonstrated better discriminatory performance with higher AUC and C-index and lower AIC and BIC values compared with the modified NIH criteria.ConclusionsRegarding prognostic evaluation, the TNM staging system was comparable to the modified NIH criteria for patients with gastric GISTs, but it outperformed the modified NIH criteria in the prediction of outcomes for patients with small intestine and colorectal GISTs.
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spelling doaj-art-38a4a44da96c41be9278fc225ddf29c82025-08-20T04:03:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16227771622777Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective studyJin-hu Chen0Zhen-rong Yang1Zhi-ming Cai2Tao Lin3Ren Lin4Xin-cheng Su5Rong-bin Kang6Lu Lin7Zai-sheng Ye8Yong-jian Zhou9Department of Gastric Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, ChinaDepartment of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, ChinaBackgroundIn 2009, the American Joint Commission on Cancer incorporated the gastrointestinal stromal tumours (GISTs) risk classification into the tumour, node, metastasis (TNM) staging system. We aimed to evaluate the prognostic value of the TNM staging system for GISTs by directly comparing it with the modified National Institutes of Health (NIH) criteria.Materials and methodsWe /used data from the Surveillance, Epidemiology, and End Results (SEER) database (2010–2019) to retrospectively analyse patients with gastric and small intestinal/colorectal GISTs. Multivariate Cox regression analysis was performed to identify independent prognostic factors for cancer-specific survival (CSS). To assess the predictive performance of the TNM staging system and the modified NIH criteria, we calculated the area under the receiver operating characteristic curve (AUC), concordance index (C-index), Akaike information criterion (AIC), and Bayesian information criterion (BIC).ResultsOf the 3,034 patients included, 2,106 had gastric GISTs and 928 had small intestinal/colorectal GISTs. Multivariate Cox analysis revealed that TNM stage was an independent prognostic factor for CSS. According to the modified NIH criteria, both the overall and subgroup cohorts exhibited better CSS in the low-risk group than that in the very low-risk group. In contrast, for the TNM staging system, the difference in CSS between stages IIIA and IIIB were not statistically significant (all P>0.05). Notably, only 2 of the 928 patients with small intestinal/colorectal GISTs met the modified NIH criteria for intermediate risk. In the gastric GISTs cohort, the AUC, C-index, AIC, and BIC values for the TNM staging system and the modified NIH criteria were similar. However, in the small intestine and colorectal GISTs cohort, the TNM staging system demonstrated better discriminatory performance with higher AUC and C-index and lower AIC and BIC values compared with the modified NIH criteria.ConclusionsRegarding prognostic evaluation, the TNM staging system was comparable to the modified NIH criteria for patients with gastric GISTs, but it outperformed the modified NIH criteria in the prediction of outcomes for patients with small intestine and colorectal GISTs.https://www.frontiersin.org/articles/10.3389/fonc.2025.1622777/fullgastrointestinal stromal tumoursNational Institutes of Health (NIH) criteriaTNM staging systemcancer-specific survivalprognostic model
spellingShingle Jin-hu Chen
Zhen-rong Yang
Zhi-ming Cai
Tao Lin
Ren Lin
Xin-cheng Su
Rong-bin Kang
Lu Lin
Zai-sheng Ye
Yong-jian Zhou
Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
Frontiers in Oncology
gastrointestinal stromal tumours
National Institutes of Health (NIH) criteria
TNM staging system
cancer-specific survival
prognostic model
title Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
title_full Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
title_fullStr Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
title_full_unstemmed Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
title_short Comparative study of National Institute of Health criteria and TNM staging system in predicting the prognosis of gastrointestinal stromal tumours: a retrospective study
title_sort comparative study of national institute of health criteria and tnm staging system in predicting the prognosis of gastrointestinal stromal tumours a retrospective study
topic gastrointestinal stromal tumours
National Institutes of Health (NIH) criteria
TNM staging system
cancer-specific survival
prognostic model
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1622777/full
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