Factors Affecting Clinical Outcomes in Women with Non-Gastric Gastrointestinal Stromal Tumors

Abstract

Background: Knowledge of the clinical outcome of women with non-gastric gastrointestinal stromal tumors (GISTs) is important for preoperative and postoperative consultation, especially for gynecologic oncologist. The aim of this study is to elucidate the factors affecting the clinical outcome of women with non-gastric GISTs.Methods: Between January 2000 and October 2019, all consecutive women with non-gastric GIST who underwent surgeries in a tertiary referral center were reviewed.Results: Among 26 women with non-gastric GISTs, eight (31%) women had recurrence or metastasis. Common clinical presentations included abdominal pain/fullness (n=12, 46%) and tarry/bloody stool (n=7, 27%). The primary locations of the tumors included the intestines (n=24) and an undetermined origin (n=2). Five (19%) women were initially admitted to the gynecologic department. Twenty-four (92%) patients underwent laparotomic tumor resection, and 2 (8%) patients underwent laparoscopic tumor resection. The probabilities of recurrence-free survival (RFS) at 60 and 120 months were 65.2% and 55.9%, respectively. Death occurred in seven (26.9%) women. The probabilities of overall survival (OS) at 60 and 120 months were 71.1% and 63.9%, respectively. Cancer stage was the only independent predictor for RFS (hazard ratio=6.00, p=0.007) and OS (hazard ratio=3.88, p=0.04). However, excluding cancer stage, metastasis (hazard ratio=8.74 for RFS, 6.03 for OS) and tumor size (hazard ratio=1.20 for OS) were independent predictors. Tumor size ≥ 13.9 cm was the optimum cut-off value to predict death and had an area under the receiver operating characteristic curve of 0.75 (95% confidence interval=0.53 to 0.98).Conclusions: Non-gastric GIST may mimic gynecologic adnexal tumors. In addition to cancer stage, metastasis and tumor size (especially ≥ 13.9 cm for OS) remain independent predictors for RFS and OS in women with non-gastric GIST. The above findings may be used for consultation.Trial registration: ClinicalTrials.gov NCT04256226