Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone

Kösemehmetoğlu, Kemal; Kaygusuz, Gülşah; Fritchie, Karen; Aydın, Övgü; Yapıcıer, Özlem; Çoşkun, Öznur; Karataylı, Ersin; Boyacigil, Senay; Güler, Gülnur; Dervışoğlu, Sergülen; Kuzu, Işınsu

doi:10.1007/s00428-017-2138-7

Cited by 15 publications

(10 citation statements)

References 59 publications

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“…Positivity for CD117 (the C-kit marker) is very common [2,3]. In our case series, the CD117 and CD34 positivity rates were 92.3% and 50%, respectively, similar to rates described in the literature [7,8]. The actin positivity rate was 69.2%, higher than reported previously; the desmin positivity rate (15.4%) was also rather high [9][10][11].…”

Section: Discussionsupporting

confidence: 85%

Are gastrointestinal stromal tumours really asymptomatic?

Emre¹

2018

Ann Clin Anal Med

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Aim: Gastrointestinal stromal tumours (GISTs) detected incidentally during abdominal surgical interventions or imaging may cause serious morbidity and mortality. We retrospectively investigated the histopathological diagnoses of GISTs made in our clinic and possible symptoms caused by the tumours prior to diagnosis. Material and Method: We retrospectively reviewed the files of patients who underwent surgery in the general surgery clinic of Kahramanmaras SutcuImam University between April 2012 and January 2017 and who were histopathologically diagnosed with GISTs; all were included in the study. Demographic data including age and sex, and data on preoperative complaints at the time of admission, tumour location, metastasis, local recurrence, and death were obtained. Results: The mean male and female patient ages were 57.1 ± 15.2 and 51.3 ± 15.3 years, respectively. Abdominal pain was the most common symptom (46.2%); other symptoms included weight loss, a palpable abdominal mass, constipation, incontinence, and lower gastrointestinal tract bleeding. The ileum was the most frequently involved region of the gastrointestinal tract (30.8%); other affected areas included the jejunum, lower intestinal tract, omentum, rectum, peritoneum, stomach, and pancreas. The CD117 positivity rate was 92.3%, the CD34 positivity rate was 50%, the actin positivity rate was 69.2%, and the desmin positivity rate was 15.4%. Discussion: GISTs are generally found incidentally, but they are accompanied by some symptoms in most of patients. However, as the symptoms are shared by many diseases, they are often overlooked by doctors and patients; these tumours are not diagnosed in a timely manner.

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Section: Discussionsupporting

confidence: 85%

Are gastrointestinal stromal tumours really asymptomatic?

Emre¹

2018

Ann Clin Anal Med

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“…In GIST, CD117 expression and activation is associated with worse prognosis and bone metastasis. [53]- [56] However, activating mutations have only been found in GIST despite increased expression in prostate and ovarian cancers among others. [21], [52], [57] CD117 expression in many cancers is associated with shorter disease survival and metastasis and is increased with cancer progression in prostate cancer patients with the highest levels of CD117 staining seen in bone metastases.…”

Section: Discussionmentioning

confidence: 99%

CD117/c-kit Defines a Prostate CSC-Like Subpopulation Driving Progression and TKI Resistance

Harris

Shi

Foster

et al. 2018

Preprint

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Cancer stem-like cells (CSCs) are associated with cancer progression, metastasis, and recurrence, and may also represent a subset of circulating tumor cells (CTCs). In our prior study, CTCs in advanced prostate cancer patients were found to express CD117/ckit in a liquid biopsy. Whether CD117 expression played an active or passive role in the aggressiveness and migration of these CTCs remained an open question. In this study, we show that CD117 expression in prostate cancer patients is associated with decreased overall and progression-free survival and that activation and phosphorylation of CD117 increases in prostate cancer patients with higher Gleason grades. To determine how CD117 expression and activation by its ligand stem cell factor (SCF, kit ligand, steel factor) alter prostate cancer aggressiveness, we used LNCaP-C4-2 and PC3-mm human prostate cancer cells, which contain a CD117+ subpopulation. We demonstrate that CD117+ cells display increased proliferation and migration. In prostaspheres, CD117 expression enhances sphere formation. In both 2D and 3D cultures, stemness marker gene expression is higher in CD117+ cells. Using xenograft limiting dilution assays and serial tumor initiation assays, we show that CD117+ cells represent a CSC population.Combined, these data indicate that CD117 expression potentially promotes tumor initiation and metastasis. Further, in cell lines, CD117 activation by SCF promotes faster proliferation and invasiveness, while blocking CD117 activation with tyrosine kinase inhibitors (TKIs) decreased progression in a context-dependent manner. We demonstrate that CD117 expression and activation drives prostate cancer aggressiveness through the CSC phenotype and TKI resistance.Harris 3

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“…In a recent study of GIST metastases, the incidence of bone metastases in GIST was limited to only 0.47%, 9 much less than that in previous reports of 3.2-6%. 2,15 Not unexpectedly, GIST metastasis to the bone may become more prevalent due to extensive use of imaging techniques and increased patient life expectancy resulting from the improvement in therapeutic modalities. Nevertheless, only 45 cases of bone metastases were included in this study after searching the whole database.…”

Section: Discussionmentioning

confidence: 99%

“…6,12,36 According to previous reports, patients with bone metastasis had a poorer prognosis (median overall survival: 18 months) than patients with metastasis in other sites or without metastasis. 2,9 Due to the limited obtained from case reports, we can only know that the mean survival of GIST patients with bone metastases was more than 64.02 months. According to our statistics, the male patients may have a longer survival than the female (65.10 and 61.55 months, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract and is considered to have a potential malignant tendency. [1][2][3] The term GIST, which was purposed by Mazur and Clark in 1983, covered a heterogeneous group of nonepithelial neoplasms with spindle or epithelioid cells. 4 Previously, GIST was considered to be a type of sarcoma and was usually misdiagnosed as either smooth muscle cell-derived or neurogenic malignancy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Bone Metastases of Gastrointestinal Stromal Tumor: A Review of Published Literature</p>

Yang¹,

Yan²,

Zeng³

et al. 2020

CMAR

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Background: With the occurrence and improvement of immunohistochemistry and other pathological diagnostic techniques, gastrointestinal stromal tumor (GIST) has been gradually recognized. With the prolonged survival of patients with GISTs, reports about the bone metastasis of GIST increased. However, the knowledge of GISTs is rather limited due to its very low incidence. Methods: Cochrane and Medline database (via PubMed) were searched in July 2019 with related keywords to acquire the literature related to the bone metastasis of GIST. Then, the literature was reviewed and references were also scanned to identify the possible related reports. Study data comprising age, sex, primary location, metastasis interval time, immunohistochemistry index, management and prognosis were recorded and analyzed. Results: Forty-five patients with bone metastases of GIST, with a mean age of 61.09 years, were included. The small intestine and stomach were the most common primary sites, followed by the rectum. Patients with small intestine primary sites had bone metastases that occurred earlier than the bone metastases stomach and rectum primary sites. The spine was the most common site of bony metastases. The mean survival time after GIST diagnosis was more than 64.02 months. Patients younger than 60 years old had a worse prognosis than those older than 60 years old. Furthermore, patients with spinal involvement had a worse prognosis than those without spinal involvement. Surgical interventions combined with targeted therapies guaranteed a better prognosis. Conclusion: Bone metastasis of GIST, which mainly occurs in the spine, is rather rare. Patients with GISTs of the small intestine and stomach suffered from bone metastasis more frequently and earlier than patients with GISTs in other primary sites. Age, sex, primary tumor location, treatment mode for the primary lesions and metastases, and spine involvement may be potential factors that affect the prognosis of GIST patients with bone metastases.

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Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone

Cited by 15 publications

References 59 publications

Are gastrointestinal stromal tumours really asymptomatic?

Are gastrointestinal stromal tumours really asymptomatic?

CD117/c-kit Defines a Prostate CSC-Like Subpopulation Driving Progression and TKI Resistance

<p>Bone Metastases of Gastrointestinal Stromal Tumor: A Review of Published Literature</p>

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