Gastrointestinal Stromal Tumors: Actin Expression, a New Prognostic Factor?

Abstract

The aim of this study is to analyze the clinical outcome of gastrointestinal stromal tumors (GISTs) and to determine new prognostic factors. We perform a retrospective study of all the patients diagnosed with GIST in any location and operated on between 2000 and 2008 at our institution. We analyzed 35 patients, 16 males (45.7%) and 19 females (54.3%), with a mean age of 64 ± 13.8 years. The tumors were located in the stomach in 22 patients (62.9%), in the small bowel in 10 (28.6%), and the retroperitoneum in three (8.6%). Referring to gastric GIST, endoscopy revealed an ulceration in the mucosa in five cases, suggesting an epithelial neoplasm. In all these cases, pathology of the biopsy specimen was nonconclusive. Survival rate at 1 and 5 years was 94.3 and 88.6 per cent, respectively. Disease-free survival at 1 and 2 years was 91.4 and 88.6 per cent, respectively. Analyzing prognostic factors, a lower disease-free survival was observed among patients with constitutional syndrome at diagnosis ( P = 0.000), small bowel GIST ( P = 0.037), and tumors not expressing actin ( P = 0.015). A lower global survival was observed among men ( P = 0,036), patients with an abdominal mass ( P = 0.033) or with constitutional syndrome ( P = 0.007) at diagnosis and tumors at a retroperitoneal location ( P = 0.0002). Gastric GIST may be confused with epithelial neoplasms, modifying the surgery. In our patients, masculine gender, constitutional syndrome and abdominal mass at diagnosis, small bowel and retroperitoneal location, and actin negative tumors are bad prognostic factors.

Primary Extra-gastrointestinal Stromal Tumor of Retroperitoneum

“…4,18,22,23,25,26,32,58 However, incidence, histogenesis, clinical and prognostic factors of EGISTs are not defined yet. 4,13–15,18,27–32,58 EGISTs show staining of KIT, marker of Interstitial Cells of Cajal which are normally present just in the gut wall. 4,18,27,32 The reason why this kind of cells, which normally are in the gut wall, can stay in the retroperitoneum, omentum or mesentery and originate a tumor is not clear yet.…”

“…More rarely neoplasms with histology and immunohistochemistry similar to GISTs may occur outside the gastrointestinal tract (omentum, mesentery and retroperitoneum) and are so-called Extra-gastrointestinal Stromal Tumors (EGISTs). 4,10,12,15,18,25–32,58…”

“…Pathogenesis, incidence, clinicopathological features and prognosis of EGISTs have not been completely defined yet. 4,13–15,18,27–32,58…”

Vulvada Paraüretral Ekstragastroi̇ntesti̇nal Stromal Tümör; Olgu Sunumu

“…Ruiz-Tovar ve ark. bir multivaryete analizde erkek cinsiyet, metabolik sendrom, tanı konulmuş abdominal kitle, ince bağırsak ve retroperitondaki tümörler ile aktin-negatif tümörlerin kötü prognistik faktörler olduğunu ortaya koymuşlardır (22…”

Proteomic approach toward personalized sarcoma treatment: Lessons from prognostic biomarker discovery in gastrointestinal stromal tumor

“…We speculate that pfetin is not the only prognostic biomarker, and other candidates should be discovered by different proteomic approaches than 2D‐DIGE. Indeed, although our studies are the only ones using the proteomic approach for biomarker discovery in GIST, many prognostic molecular biomarkers were reported in previous genetic and epigenetic studies . We may want to finally focus on a single or a few biomarkers for clinical applications, and the appearance of more and more biomarkers may become an obstacle to their practical application.…”