AUTHOR=Zhang Yue , Liu Qi , Ma Bing , Xu Hao TITLE=Age-dependent diminution of female prognostic advantage in gastrointestinal stromal tumors: a retrospective cohort analysis JOURNAL=Frontiers in Immunology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1617019 DOI=10.3389/fimmu.2025.1617019 ISSN=1664-3224 ABSTRACT=BackgroundSex and age are significant factors influencing the prognosis of various types of cancer. However, the impact of sex and age on the prognosis of gastrointestinal stromal tumors (GISTs) remains unclear. Investigating the interaction between sex and age may facilitate a more precise assessment of the prognosis of GISTs.MethodsA retrospective analysis was conducted on a cohort of 5318 patients with GISTs, utilizing the Cox regression model to analyze the disparities in disease-specific survival (DSS) across sex. Subsequently, the cohort after propensity score matching was employed to investigate the prognostic differences attributable to age variations, and restricted cubic spline analysis was utilized to assess the prognostic disparities associated with different sexes and ages in GIST.ResultsThis investigation demonstrated substantial sex-based disparities in the clinical characteristics of GIST. With respect to prognosis, males exhibited a significantly elevated hazard ratio (HR) for DSS in comparison to females (HR = 1.40, p<0.001), which persisted following multivariate (HR = 1.38, p=0.006) and propensity score matching analyses (HR = 1.36, p=0.014). Moreover, a significant interaction between age and sex was observed in predicting DSS, notably indicating that younger female subjects (≤50 years) demonstrated a more favorable prognosis relative to their male counterparts.ConclusionsFemale patients with GIST exhibit a more favorable prognosis than males, with this advantage decreasing with advancing age.