Gastrointestinal stromal tumor: 15-years’ experience in a single center

Abstract

BackgroundGastrointestinal stromal tumor (GIST) is known for its wide variability in biological behaviors and it is difficult to predict its malignant potential. The aim of this study is to explore the characteristics and prognostic factors of GIST.MethodsClinical and pathological data of 497 GIST patients in our center between 1997 and 2012 were reviewed.ResultsPatients were categorized into very low-, low-, intermediate- and high-risk groups according to modified National Institutes of Health (NIH) consensus classification system. Among the 401 patients untreated with imatinib mesylate (IM), 5-year overall survival (OS) in very low-, low-, intermediate- and high-risk groups was 100%, 100%, 89.6% and 65.9%; and 5-year relapse-free survival (RFS) was 100%, 98.1%, 90.9% and 44.5%, respectively. Univariate analysis revealed that sex, tumor size, mitotic rate, risk grade, CD34 expression, and adjacent involvement were predictors of OS or RFS. COX hazard proportional model (Forward LR) showed that large tumor size, high mitotic rate, and high risk grade were independent risk factors to OS, whereas high mitotic rate, high risk grade and adjacent organ involvement were independent risk factors to RFS. The intermediate-high risk patients who received IM adjuvant therapy (n = 87) had better 5-year OS and RFS than those who did not (n = 188) (94.9% vs. 72.1; 82.3% vs. 56.3%, respectively). Similarly, advanced GIST patients underwent IM therapy (n = 45) had better 3-year OS and 1-year progression-free survival (PFS) than those who didn’t (n = 42) (75.6% vs. 6.8%; 87.6% vs. 12.4%, respectively).ConclusionsVery low- and low-risk GISTs can be treated with surgery alone. Large tumor size, high mitotic rate, high risk grade, and adjacent organ involvement contribute to the poor outcome. IM therapy significantly improves the survival of intermediate-high risk or advanced GIST patients.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2482-14-93) contains supplementary material, which is available to authorized users.

Gastrointestinal Stromal Tumour (GIST): Experience on 20 Patients

“…GISTs have no specific symptom, increasing the difficulty in early diagnosis and treatment. In our data, the most frequent complaint is abdominal lump (70%) which is consistent with other literature 9,[12][13] . Abdominal pain and discomfort are present in 45% of cases.…”

Gastrointestinal Stromal Tumors: Clinical Symptoms, Location, Metastasis Formation, and Associated Malignancies in a Single Center Retrospective Study

“…A recently published large single center study ( n = 497) investigating tumor recurrence in GIST patients found a slightly higher risk of overall tumor recurrence or metastasis formation which was 19.7% [38]. However, hardly any tumor relapse was observed in the low risk and very low risk groups.…”

Standard Approach to Gastrointestinal Stromal Tumors - Differences between China and Europe

“…Although most evidence and clinical guidelines for the treatment and management of GISTs have been established in Western countries, Asian patients have supplied limited data regarding the diagnosis and treatment of GIST. It is unclear whether these guidelines are appropriate for the clinical situation in Asian countries, especially China, given the long-lasting experience of selected Chinese centers [13]. The Chinese consensus guidelines for the diagnosis and management of GISTs were formulated in 2013 and updated in 2017, and differ from those of European countries in terms of clinical practice patterns [5].…”