Joensuu classified gastrointestinal stromal tumors (GIST) into risk categories. This is similar to other classification scheme but includes tumor rupture as a risk factor. The author is from Helsinki University in Finland.
Patient selection: GIST
Parameters:
(1) diameter of the tumor in cm
(2) mitotic rate per 50 high power microscopic fields (hpf)
(3) primary tumor site
(4) tumor rupture
High risk tumors include any of the following:
(1) tumor rupture
(2) diameter > 10 cm
(3) mitotic rate > 10 per 50 hpf
(4) diameter > 5 cm AND mitotic rate > 5 per 50 hpf
Tumor rupture may occur:
(1) spontaneously
(2) following trauma
(3) during surgery if the lesion is not handled carefully
Diameter
Mitotic Rate
Tumor Site
Risk Group
<= 2 cm
<= 5
any
very low risk
2.1 to 5.0 cm
<= 5
any
low
<= 5.0 cm
6 to 10
gastric
intermediate
<= 5.0 cm
6 to 10
non-gastric
high risk
5.1 to 10 cm
<= 5
gastric
intermediate
5.1 to 10 cm
<= 5
non-gastric
high risk
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