Gastrointestinal stromal tumors and second primary malignancies: a retrospective monocentric analysis

Abstract

In the post-Imatinib era, the median survival of patients diagnosed with GIST has reached almost 5 years. Prolonging GIST-specific survival, GIST patients have an increased incidence of secondary neoplasia. Data on the prognostic impact of second tumors in GIST patients are very poor with few and small retrospective analyses available in the literature. We conducted a retrospective monocentric analysis on 145 patients diagnosed with GIST between April 2001 and October 2018. Kaplan-Meier and Cox hazard methods were used for survival analysis. A total of 154 GIST patients were included and 31 patients of them (21%) were diagnosed with at least one additional malignancy. The most common second tumors associated with GIST were gastrointestinal tumors. GIST patients with additional malignancies showed to have lower size (>5 cm: 35% vs 45%; p = 0.75), higher mitotic rate (> 5/50 HPFs: 42% vs 29%; p = 0.24), higher presence of cKIT mutation (85% vs 69%), a lower pres ; p = 0.05) and shorter survival (mOS: 9.6 vs 15.5 years; p = 0.30). In conclusion, our study did not find any significant correlation between clinicopathological characteristics and the development of a second tumor in GIST patients. Further analyses and strict follow up protocols are needed in order to early diagnose and promptly treat a second primary tumor in the GIST population.

Comparative Study on the Clinical Effects of Different Surgical Methods in the Treatment of Gastrointestinal Stromal Tumors

“…Once GISTs occur, patients usually lack typical symptoms, and their main clinical manifestations are gastrointestinal bleeding, abdominal pain, nausea, belching, obstruction, etc. If the GISTs condition worsens, resulting in tumor volume enlargement or ulceration, the patient may have symptoms such as severe abdominal pain, hematemesis, and black stool [ 3 , 4 ]. At present, surgery is a widely used GIST treatment in clinics.…”

The association of genitourinary cancer among Saudi patients with gastrointestinal stromal tumors and a systematic literature review

“…A total of 69 articles were reviewed. Seventeen articles reported the prevalence of genitourinary cancer associated with GIST ranging 2.1-15.6% (Table 2) [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] . Prostatic adenocarcinoma was the most common primary genitourinary cancer (2.1-14%), followed by RCC (0.6-11.4%).…”

Second Primary Tumors in Patients with Gastrointestinal Stromal Tumors: A Single-Center Experience

“…In the study conducted by Kramer et al, this rate was found to be 31.9% and 42%, respectively, in two different multicenter and single-center cohorts [18]. This rate was reported to be 21% in a retrospective monocentric analysis by Comandini et al [19]. Although varying rates have been reported in literature, the association of GISTs with secondary tumors was reported to be 20% in a meta-analysis performed in 2019 [11,12].…”

“…In two different large-scale analyses conducted in 2019, it was reported that among SPMTs accompanying GISTs, hematological malignancies were lesser (6%) compared to gastrointestinal and genitourinary system tumors [ 11 , 12 ]. Lymphoma and leukemia are frequently observed in hematological tumors [ 12 , 19 ].…”

“…There are a limited number of studies in literature regarding the prognostic effects of SPMTs accompanying GISTs. There are publications, however, predicting shorter survival in cases of concurrent coexistence [ 18 , 19 , 21 ].…”