All but two of the patients who later experienced recurrence had at least one genomic alteration involving CDKN2A/B, RB1, or TP53. Notably, cell cycle-related genetic events were associated with higher number of mitoses in primary GISTs (Fig. 4a), a well-recognized risk factor for the development of metastatic disease. Here, CDKN2A is linked to metastatic neoplasm.