Thirty-three patients were included in this retrospective study who were treated by surgical resection of malignant stromal tumors of the gastrointestinal tract and confirmed histologically from 1975 to 1994. To determine the prognostic factors,
we
analysed several clinico-pathologic variables, such as patient's age, sex, tumor location, tumor size, tumor necrosis, adjacent organ invasion and/or metastasis, cellularity, atypism, and mitosis count. Additionally, the nucleolar organizer
region
staining(AgNOR staining) and immunostaining of proliferating cell nuclear antigen(PCNA) were used to assess the cellular proliferating activities. A univariate analysis using Kaplan-Meir method and log-rank statistics revealed following
significant
prognostic factors; 1) tumor location(p=0.0348), 2) tumor invasion and/or metastasis(p=0.0010), 3) Curative resection(p=0.0004), 4) tumor size(p=0.00216) 5) PCNA index(p=0.0404), and 6) numbers of AgNORs(p=0.0118). Mitotic count, together with
PCNA
index, has significant correlation with AgNORs count in the Pearson's correlation analysis. The other pathologic variables such as tumor necrosis, cellula5rity, atypism and mitosis count were not significantly correlated with survival rete.
Furthermore,
some patients who had local recurrence and/or distant metastasis survived longer after resection of recurrent tumors. In view of the results, early diagnosis and aggressive surgical resection may be mandatory to improve patient's survival and it
is
necesssary to follow up closely of the patients who has high cellular proliferating activities of the tumor.
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