Long-term survival among patients with gastrointestinal stromal tumors diagnosed after another malignancy: a SEER population-based study

Abstract

Background: To explore overall survival (OS) and GISTs-specific survival (GSS) among cancer survivors developing a second primary gastrointestinal stromal tumors (GISTs). Methods: We conducted a cohort study, where patients with GISTs after another malignancy (AM-GISTs, n = 851) and those with only GISTs (GISTs-1, n = 7660) were identified from the Surveillance, Epidemiology, and End Results registries (1988-2016). Clinicopathologic characteristics and survival were compared between the two groups. Results: The most commonly diagnosed first primary malignancy was prostate cancer (27.7%), followed by breast cancer (16.2%). OS among AM-GISTs was significantly inferior to that of GISTs-1; 10-year OS was 40.3% vs. 50.0%, (p < 0.001). A contrary finding was observed for GSS (10-year GSS 68.9% vs. 61.8%, p = 0.002). In the AM-GISTs group, a total of 338 patients died, of which 26.0% died of their initial cancer and 40.8% died of GISTs. Independent of demographics and clinicopathological characteristics, mortality from GISTs among AM-GISTs patients was decreased compared with their GISTs-1 counterparts (HR, 0.71; 95% CI, 0.59-0.84; p < 0.001), whereas OS was inferior among AM-GISTs (HR, 1.11; 95% CI, 0.99-1.25; p = 0.085). Conclusions: AM-GISTs patients have decreased risk of dying from GISTs compared with GIST-1. Although another malignancy history does not seemingly affect OS for GISTs patients, clinical treatment of such patients should be cautious.

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%).…”

Combining Three Tyrosine Kinase Inhibitors: Drug Monitoring Is the Key

“…In addition, the improvement in tumor control due to the progress of targeted therapies leads to an increase in the longevity of patients who are more likely to develop a second cancer. This type of situation requiring the combination of several TKIs is likely to be encountered more frequently in the years to come [ 23 ]. The main objective will be to maintain optimal anti-tumor activity while ensuring acceptable tolerance.…”

Naples prognostic score, a novel prognostic score for patients with high- and intermediate-risk gastrointestinal stromal tumours after surgical resection

“…GISTs, as a low incidence gastrointestinal tumour, are gradually gaining the attention of oncologists, surgeons, and gastroenterologists. In addition to studies on the clinical characteristics and prognosis of gastrointestinal stromal tumours, such as the long-term survival of patients with gastrointestinal stromal tumours diagnosed after malignant tumours [ 45 ], the whole-process management of gastrointestinal stromal tumours is gradually enriched and improved, such as preoperative adjuvant therapy for locally advanced and recurrent/metastatic gastrointestinal stromal tumours [ 46 ]. However, in clinical diagnosis and treatment, concise and efficient prognostic evaluation criteria are still the most concerned issue for clinicians; we calculated and compared all the commonly used prognostic markers and found that the Naples score may be the most practical comprehensive evaluation system.…”