Prognostic factors affecting survival after surgical resection of gastrointestinal stromal tumours: a two-unit experience over 10 years

Chiappa, Antonio; Zbar, Andrew P.; Innis, Michael A.; Garriques, Stuart; Bertani, Emilio; Biffi, Roberto; Pruneri, Giancarlo; Luzzato, Felipe; Vigna, Paolo Della; Trovato, C.; Andreoni, Bruno

doi:10.1186/1477-7819-4-73

Cited by 5 publications

(3 citation statements)

References 46 publications

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“…16 Five year overall survival following R0 resection is satisfactory (88%) while it can reach 0% following palliative surgery. 17 The postoperative treatment of palliated patients includes targeted therapy with Imatinib mesylate (400 mg per day), which is a tyrosine kinase inhibitor. The current data demonstrate a response in 50% of these cases and a continued response in 75%.…”

Section: Discussionmentioning

confidence: 99%

“…20 It is difficult to predict the biological behaviour and outcome of these tumours however the most reliable prognostic factors are the site, size and mitotic index for management point of view. 17 On the basis of these factors two risk classifications have been proposed. 4 The biological features of these tumours represent important prognostic factors predicting outcome.…”

Section: Discussionmentioning

confidence: 99%

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GIST a rare abdominal tumor and our surgical experience

et al. 2022

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Background: GISTs are rare abdominal tumors, encountered as the most common mesenchymal neoplasms of the gastrointestinal (GI) tract leading to GI bleeding. We report a changing trend of diagnosis and management in Indian patients.Methods: The retrospective data was collected from medical records and 62 cases of GIST from 2003 to 2020 in General surgical unit of BHU. They were divided in three groups. In group A (36) patients only surgery, group B (14) patients surgery than adjuvant chemotherapy and in group C (12) who received neoadjuvant chemotherapy then surgery. Preoperatively, USG and CT scans of the abdomen were the main investigations, others being upper gastrointestinal endoscopy and chest x-ray confirm by histopathological and immunohistochemical evaluation.Results: The mean age at presentation was 42.8 years (range 17-74 years) and mean duration of symptoms was of 5 months (range 10 days-2 years). It was from the stomach, (06) duodenum (14) jejunum, (06) ileum, (1) caecum and (4) from the mesentery and (4) from retroperitoneum. 44 cases had low grade benign tumors and 18 malignancies. In group A, 22 (61%) patients showed recurrence in group B, 06, (42%) patients showed recurrence and group C, 02 (33%) patient showed recurrence.Conclusions: Most of the tumours were benign and surgical resection is the mainstay of treatment. However, the patients in which only surgery was done showed maximum recurrence and patients who received neoadjuvant chemotherapy then surgery followed adjuvant chemotherapy showed minimum recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

GIST a rare abdominal tumor and our surgical experience

et al. 2022

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“…Therefore in our study management of the patients treated for GIST pre and post c-kit staining was the same. Previous studies have reported 5 year survival following complete resection between 35-75% [ 8 , 10 , 14 - 16 ]. Our findings suggest even higher 5 year survival rates can be achieved.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Stromal Tumours treated before and after the advent of c-kit immunostaining

et al. 2011

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BackgroundRecently developed immunohistochemical markers have revolutionised the classification of gastrointestinal stromal tumours (GISTs) whilst tyrosine kinase inhibitors (imatinib) have had a significant impact on the treatment of advanced tumours. We review the clinicopathological features of previously resected mesenchymal tumours of the gastrointestinal tract in our institution to 1) reclassify the histological diagnosis of those stained prior to c-kit availability; 2) perform survival analysis to identify prognostic factors, and 3) to consider the implications for patients.MethodsClinicopathological records of patients with a diagnosis of mesenchymal tumours treated between May 1992 and April 2007 were reviewed.Results82 patients were reviewed. 26 (32%) were reclassified as GISTs following c-kit immunostaining and a further 14 patients were treated for GIST up to April 2007 (Total: 40 patients; 21 males and 19 females, mean age 67, range 30-92 years). 36 (90%) underwent complete resection. 5-year survival of patients with GIST alone was 80%. Females had a better median survival (M: F 43 months: 73 months).ConclusionsThe availability of c-kit staining allowed 32% of previously diagnosed mesenchymal tumours to be reclassified as GISTs. This may have implications for the follow-up of patients diagnosed prior to the availability of this method.

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Prognostic value of tumor necrosis in gastrointestinal stromal tumor

Yi¹,

Lin²,

Zhou

et al. 2019

Medicine

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Background and aims:There is currently no consensus regarding the influence of tumor necrosis on the prognosis of gastrointestinal stromal tumors (GISTs). Therefore, we conducted a meta-analysis to determine the prognostic role of tumor necrosis in patients with GIST.Methods:PubMed, Embase, and Web of Science electronic databases were searched from their inception to March 2018. Studies reporting data on the relationship between tumor necrosis and GIST prognosis were eligible. The measure of the effect of interest was the odds ratios (ORs) with 95% confidence intervals (CIs). This study has been registered in the Prospero (number CRD42018096036).Results:In total, 18 studies including 2320 patients were identified. The total odds of tumor necrosis were associated with a poor GIST prognosis (OR = 5.54, 95% CI = 4.39–6.99). Subgroup analysis of different observed outcomes indicated that tumor necrosis was associated with a decreased disease-free survival (OR = 7.08, 95% CI = 4.78–10.49), recurrence-free survival (OR = 3.96, 95% CI = 2.48–6.32), and overall survival (OR = 4.29, 95% CI = 2.02–9.13). In addition, any tumor site, tumor size, follow-up time, ethnicity, different outcomes of GIST, and different degrees of positive staining of immunohistochemical markers subgroups showed a significantly increased risk of a poor prognosis.Conclusions:Tumor necrosis may likely predict a poorer prognosis for GIST. However, further well-designed prospective studies with large sample size are required in the future.

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Prognostic factors affecting survival after surgical resection of gastrointestinal stromal tumours: a two-unit experience over 10 years

Abstract: Most GISTs are resectable with survival principally dependent upon mitotic count and completeness of resection. Future metabolic and genetic analyses will define the role of and resistance to induction or postoperative adjuvant targeted kinase inhibition therapy.

Cited by 5 publications

References 46 publications

GIST a rare abdominal tumor and our surgical experience

GIST a rare abdominal tumor and our surgical experience

Gastrointestinal Stromal Tumours treated before and after the advent of c-kit immunostaining

Prognostic value of tumor necrosis in gastrointestinal stromal tumor

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