GIST (SGISR)

- For resection specimens with gastrointestinal stromal tumors

Specimen and Surgical Procedure

Specimen, procedure.................................................................... 

Tumor

Tumor site...................................................................................

Tumor size...................................................................................

Tumor focality.............................................................................. (if multifocal, specify number and size of tumors) 

GIST histologic subtype.................................................................

(examples - "spindle cell," "epithelioid," "mixed")

Mitotic rate.................................................................................. __/5 mm2*

Histologic grade............................................................................

low grade, mitotic rate ≤5/5 mm2

high grade, mitotic rate >5/5 mm2

Risk assessment...........................................................................

       

Final margins

Nearest margin............................................................................

Distance from specified margin to tumor.........................................

Other margin(s) (if applicable; please specify)..............................positive/negative

Lymph Nodes

Regional lymph nodes involved....................................... ____

Regional lymph nodes examined....................................... ____

Ancillary Studies......................................................................... yes/pending

c-kit (CD117) staining.......................................... positive/negative/not performed

DOG1 (ANO1) staining.......................................... positive/negative/not performed

Treatment Effect……………………………………..….No known Therapy/ Not Identified/Present

Pathologic stage(AJCC 8th Edition)............................................ pT__N__M__

Gastrointestinal

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Staging

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