Factors Affecting Disease-Free Survival in Operated Nonmetastatic Gastrointestinal Stromal Tumors

Sakin, Abdullah; Can, Orçun; Arıcı, Serdar; Yaşar, Nurgül; Geredeli, Çağlayan; Demir, Cumhur; Cihan, Şener

doi:10.1016/j.jss.2019.03.059

Cited by 7 publications

(14 citation statements)

References 25 publications

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“…The most common site of GIST in our study was the stomach, which is in keeping with most clinical reports [ 3 , 20 , 32 – 34 ]. The question still remains, is tumor location of any significance as a prognostic factor?…”

Section: Discussionsupporting

confidence: 91%

A Retrospective Study of Postoperative Outcomes in 98 Patients Diagnosed with Gastrointestinal Stromal Tumor (GIST) of the Upper, Middle, and Lower Gastrointestinal Tract Between 2009 and 2019 at a Single Center in Poland

et al. 2021

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Background Gastrointestinal stromal tumors (GISTs) arise in the smooth muscle pacemaker interstitial cells of Cajal, or similar cells. The aim of this retrospective study between 2009 and 2019 from a single center in Poland was to assess the selected prognostic factors (location, tumor size, mitotic index, body mass index (BMI), length of hospital stay, age, sex, and coexistent neoplasm) and to investigate postoperative outcomes in 98 patients with GIST of the upper, middle, and lower gastrointestinal tract. Material/Methods Between 2009 and 2019, 98 patients (50 women and 48 men) with an average age of 63.8 years (range from 38 to 90 years) were operated on for GIST in the Department of Gastrointestinal Surgery in Katowice, Poland. Based on the intraoperative and postoperative investigations, the tumor size and mitotic index were determined in each case. Results A statistically significant correlation between age and mitotic index (MI) was found (p=0.02). The higher the MI, the younger the age of the patients. However, regardless of sex, younger patients had a tendency to survive longer. A >60-year-old male patient’s probability of survival was around 65% after 40 months. Higher mitotic index was also associated with larger tumor size (p<0.0001). Female patients had a tendency to survive longer than males. Conclusions The findings from this small retrospective study support the importance of preoperative evaluation and frequent postoperative follow-up for patients with GIST of the gastrointestinal tract, particularly in older male patients, and patients with malignant comorbidities, which are associated with increased mortality.

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Section: Discussionsupporting

confidence: 91%

A Retrospective Study of Postoperative Outcomes in 98 Patients Diagnosed with Gastrointestinal Stromal Tumor (GIST) of the Upper, Middle, and Lower Gastrointestinal Tract Between 2009 and 2019 at a Single Center in Poland

et al. 2021

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“…One such marker is c-Kit positivity, which has been associated with favorable GIST outcome. A recent study 8 reported that c-Kit positivity was a positive predictor of DFS, insofar higher levels of this marker were associated with a better prognosis (HR = 0.239; 95% CI 0.125–0.689; p = 0.001). Corroborating this, a different study 14 also identified c-Kit as a good prognostic predictor (95% CI 0.979–0.997; p = 0.012).…”

Section: Resultsmentioning

confidence: 95%

“…Similarly, a study published in 2015 6 reported an improved RFS (HR = 0.23; 95% CI 0.07–0.80; p = 0.012) and OS (HR = 0.20; 95% CI 0.05–0.91; p = 0.021) in colorectal GIST patients receiving imatinib after surgery. Different studies have also reported an association between adjuvant therapy, longer DFS (HR = 0.365; 95% CI 0.199–0.918; p = 0.023), 8 and longer OS (HR = 0.262; 95% CI 0.122–0.563; p = 0.001). 10…”

Section: Resultsmentioning

confidence: 96%

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Prognostic Factors and Management of Colorectal Gastrointestinal Stromal Tumors

Reis

Barbosa

2022

Journal of Coloproctology

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Introduction The gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Even though it can be found in any location of the digestive tract, the colorectal GIST is rare. With this study, we aim to review the current knowledge regarding the prognosis and management of colorectal GIST. Methods A literature search was conducted in PubMed, and 717 articles were collected. After analyzing these studies, 60 articles were selected to use in this review. Results The mitotic index, as well as tumor size and location were identified as good discriminators of prognosis in various studies. Surgery remains the only curative therapy for potentially resectable tumors. However, even after surgical resection, some patients develop disease recurrence and metastasis, especially those with high-risk tumors. Therefore, surgical resection alone might be inadequate for the management of all colorectal GISTs. The discovery of GIST's molecular pathway led to a shift in its therapy, insofar as tyrosine kinase inhibitors became part of the treatment schemes for this tumor, revolutionizing the treatment's outcome and prognosis. Discussion/Conclusion The controversy concerning colorectal GIST prognosis and treatment can be, in part, attributed to the limited number of studies in the literature. In this review, we gathered the most recent knowledge about the prognosis and management of GIST in this rare location and propose two algorithms for its approach. Lastly, we highlight the importance of an individualized approach in the setting of a multidisciplinary team.

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