To develop an integrated model for risk stratification and guide adjuvant imatinib duration in non-gastric gastrointestinal stromal tumors (GISTs).
Key Findings:
The PIIS included the platelet-to-albumin ratio, platelet-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, and lactate dehydrogenase-to-albumin ratio.
Independent predictors of recurrence-free survival identified were sex, tumor size, mitotic index, Ki-67 index, and PIIS.
The integrated model showed superior discrimination with C-indices of 0.839 in the training cohort and 0.795 in the external validation cohort.
The model stratified mNIH high-risk and AFIP intermediate- and high-risk patients into low-, medium-, and high-risk groups.
Adjuvant therapy beyond 3 years improved recurrence-free survival in medium- and high-risk subgroups, with no clear benefit in the low-risk subgroup.
Interpretation:
Remove unsupported claims about enhancing recurrence risk prediction.
Limitations:
Retrospective design may introduce selection bias.
Findings may not be generalizable beyond the studied population.
Conclusion:
Revise to eliminate unsupported claims regarding clinical decision-making.
