Long-Term Surgical Outcome of 1057 Gastric GISTs According to 7th UICC/AJCC TNM System

Kim, Min Chan; Yook, Jeong Hwan; Yang, Han Kwang; Lee, Hyuk Joon; Sohn, Tae Sung; Hyung, Woo Jin; Ryu, Seung Wan; Kurokawa, Yukinori; Kim, Young Woo; Han, Sang Uk; Kim, Hyung‐Ho; Park, Do Joong; Kim, Wook; Lee, Sang Il; Cho, Haruhiko; Cho, Gyu Seok; Kim, Jin-Jo; Kim, Ki Han; Yoo, Myoung-Woo

doi:10.1097/md.0000000000001526

Cited by 31 publications

(36 citation statements)

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“…The stomach is the most commonly affected GI site in patients with a localized GIST, and is associated with the most favourable prognosis, with a 5-year survival rate of 84⋅5 per cent reported in the present study. This is comparable with survival data from other studies 33 , including a large cohort from Korea and Japan 34 . There may be a bias in these survival rates when compared to other GI locations, because gastric GISTs are generally discovered at an earlier disease stage.…”

Section: Discussionsupporting

confidence: 89%

Nationwide trends in the incidence and outcome of patients with gastrointestinal stromal tumour in the imatinib era

Graaf

Tielen

Bonenkamp

et al. 2018

British Journal of Surgery

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BackgroundThe incidence, treatment and outcome of patients with newly diagnosed gastrointestinal stromal tumour (GIST) were studied in an era known for advances in diagnosis and treatment.MethodsNationwide population‐based data were retrieved from the Netherlands Cancer Registry. All patients with GIST diagnosed between 2001 and 2012 were included. Primary treatment, defined as any treatment within the first 6–9 months after diagnosis, was studied. Age‐standardized incidence was calculated according to the European standard population. Changes in incidence were evaluated by calculating the estimated annual percentage change (EAPC). Relative survival was used for survival calculations with follow‐up available to January 2017.ResultsA total of 1749 patients (54·0 per cent male and median age 66 years) were diagnosed with a GIST. The incidence of non‐metastatic GIST increased from 3·1 per million person‐years in 2001 to 7·0 per million person‐years in 2012; the EAPC was 7·1 (95 per cent c.i. 4·1 to 10·2) per cent (P < 0·001). The incidence of primary metastatic GIST was 1·3 per million person‐years, in both 2001 and 2012. The 5‐year relative survival rate increased from 71·0 per cent in 2001–2004 to 81·4 per cent in 2009–2012. Women had a better outcome than men. Overall, patients with primary metastatic GIST had a 5‐year relative survival rate of 48·2 (95 per cent c.i. 42·0 to 54·2) per cent compared with 88·8 (86·0 to 91·4) per cent in those with non‐metastatic GIST.ConclusionThis population‐based nationwide study found an incidence of GIST in the Netherlands of approximately 8 per million person‐years. One in five patients presented with metastatic disease, but relative survival improved significantly over time for all patients with GIST in the imatinib era.

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Section: Discussionsupporting

confidence: 89%

Nationwide trends in the incidence and outcome of patients with gastrointestinal stromal tumour in the imatinib era

Graaf

Tielen

Bonenkamp

et al. 2018

British Journal of Surgery

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“…Most (61%) of the cases were classified under 'high risk'. As reported from other studies [15,16] liver was the most common site of metastasis in our patients. However, pulmonary metastases, which have been described as 'rare' in GISTs [17], and a sign of advanced disease [4], was the second most common site of metastases in our study.…”

supporting

confidence: 86%

Gastrointestinal stromal tumors in southern Iraq: clinico-pathologic patterns and risk stratification

2018

ajbm

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There was no local or nationwide data on the patterns of Gastrointestinal Stromal Tumors (GISTs) in Iraq. This study was undertaken to determine the clinical and pathologic characteristics and risk stratification of GISTs in Iraqi patients over a nine years' period. This is a retrospective descriptive study. Medical notes and histopathological reports of patients with confirmed diagnosis of GIST between January 2007 and August 2015 were reviewed for age, gender, tumor location, CD117 status, tumor stage, and National Institutes of Health (NIH) risk classification. Fortyseven patients were included in the study. Mean age at time of diagnosis was 57 years (range 29 to 85 years), and male to female ratio was 1:1. Most common sites of involvement of GISTs were stomach (21/47), and jejunum/ ileum (16/47). Immunohistochemistry for CD117 was positive in 33 cases. Out of the 47 cases, 4 were locally advanced and 15 were metastasized. The most common site for metastasis was liver (53%) followed by pulmonary (40%) and retroperitoneum (7%). Risk stratification was done for only 41 cases; 61% were stratified as high risks group, 12% belonged to intermediate risk category, while the rest 27% were stratified as very low and low risk groups. While the epidemiological patterns of GIST from Iraq resembles those from elsewhere, the disease was more advanced in Iraqi patients when compared to Western countries. At the time of diagnosis, majority of our cases were stratified under high-risk category.

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“…However, despite the similarities in IHC and genetic testing between eGISTs and GISTs, the prognoses of eGISTs are less favorable compared to GISTs as the former tends to have higher proliferative mitotic indices (GISTs vs eGISTs, median range, 4–8/50 HPF 36 – 38 vs 10–15/50 HPF 12 , 39 , 40 ), larger tumor size (GISTs vs eGISTs, median range, 4–7 cm 38 , 41 , 42 vs 7.5–15 cm 12 , 14 , 39 , 40 , 43 ) and greater risk to recurrence or distant metastasis. 14 , 44 Similarly, our findings showed that the median tumor size (13 cm, range, 0.4–29 cm) and mitotic value (13 HPF, range, 0–50 HPF) were in accordance with that of reported literature.…”

Section: Discussionmentioning

confidence: 99%

<p>Retroperitoneal Extragastrointestinal Stromal Tumors Have a Poor Survival Outcome: A Multicenter Observational Study</p>

Hu¹,

Zheng²,

Li³

et al. 2020

CMAR

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Purpose Gastrointestinal stromal tumors (GISTs) are commonly known to be derived from the gastrointestinal (GI) tract, but recently there have been more and more literature describing lesions with similar pathological and immunohistochemical resembling GISTs but located outside the GI tract, and they have been termed as extra-GISTs (eGISTs). However, due to the rare incidence of eGISTs, its association with survival outcomes is poorly understood, especially in the Chinese population. Here, we aimed to identify the risk factors of eGISTs and to assess their association with overall survival (OS) and disease-free survival (DFS). Patients and Methods Data of pathologically confirmed eGISTs cases, without radiological and perioperative evidence of other primary lesions, and with no microscopically identified adhesion between the tumor and the gastrointestinal serosa, which were surgically treated between January 2006 and September 2017 were retrieved from the database of four high-volume hospitals. Immunohistochemical and genetic testing were performed on the postoperative lesions and were staged using the National Institutes of Health (NIH) criteria. Results A total of 55 cases were retrieved. eGISTs were identified from the retroperitoneum (36.4%), mesocolon (25.5%), small bowel mesentery (12.7%), abdominopelvic cavity (12.7%), lesser omental sac (5.5%), ovary (3.6%), pancreatic capsule (1.8%), or urinary bladder (1.8%). Based on the NIH risk classification, majority of the lesion were classified as high risk (85.5%). KIT 11 was the most common mutation site (76.5%) and 25.0% of the cases were wild-type eGISTs. Multivariate analyses showed that tumor location and size were independent factors affecting prognoses. Patients with tumors in the retroperitoneum had significantly poorer OS and DFS as compared to those in the non-retroperitoneum (HR [95% CI] for OS and DFS: 2.546 [1.023–6.337] [ P = 0.037] and 2.475 [0.975–6.273] [ P = 0.049], respectively). Similar findings were found for tumors of size >15 cm, compared to ≤15 cm (HR [95% CI] for OS and DFS: 5.350 [2.022–14.156] [ P < 0.001] and 3.861 [1.493–9.988] [ P = 0.003], respectively). Conclusion eGISTs were predominantly found from the retroperitoneum and mostly classified as high risk. Those located in the retroperitoneum and of size >15 cm had the poorer OS and DFS as compared to those in the non-retroperitoneum and of size <15 cm.

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Long-Term Surgical Outcome of 1057 Gastric GISTs According to 7th UICC/AJCC TNM System

Cited by 31 publications

References 15 publications

Nationwide trends in the incidence and outcome of patients with gastrointestinal stromal tumour in the imatinib era

Nationwide trends in the incidence and outcome of patients with gastrointestinal stromal tumour in the imatinib era

Gastrointestinal stromal tumors in southern Iraq: clinico-pathologic patterns and risk stratification

<p>Retroperitoneal Extragastrointestinal Stromal Tumors Have a Poor Survival Outcome: A Multicenter Observational Study</p>

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