Management of Patients with Gastrointestinal Stromal Tumors: Experience from an Italian Hospital

Abstract

Gastrointestinal stromal tumors are malignancies originating from stromal/mesenchymal tissues, most commonly in the stomach and small intestine, although they can be located everywhere in the gastrointestinal tract. Diagnosis is based on histological and immunohistochemical examination, and these rare tumors are characterized by c-kit (CD117) staining. Complete removal of the tumor is often curative in localized gastrointestinal stromal tumors and is always recommended. Clinically, their behavior is difficult to predict, and mitotic count and tumor size seem to be the most effective prognostic factors. We performed a retrospective analysis of clinical presentation and course, surgical management and pathological features of patients with gastrointestinal stromal tumors treated in our institution from 1995 to 2003. Twenty-two patients were enrolled in the study, and all of them underwent surgery. There were two perioperative deaths, and global morbidity was about 13%. Nineteen patients were followed (mean, 31 months): 4 patients had disease progression/recurrence and died, and one patient experienced a local recurrence and was reoperated with a curative intent; 14 patients were disease free. Our experience shows that histological and immunohistochemical examinations are fundamental for a definitive diagnosis and to assess the risk of aggressive behavior. Moreover, our results confirm that in stromal tumors complete surgical resection remains the mainstay of treatment in localized gastrointestinal stromal tumors, although the recurrence rate is relatively high. It is conceivable that treatment and prognosis of metastatic and non-resectable gastrointestinal stromal tumors, as well as the adjuvant treatment of high-risk, radically excised gastrointestinal stromal tumors will be strongly impacted by the c-kit target therapy.

Gastrointestinal Stromal Tumors (GISTs), Surgical Management and Clinical Outcome

“…Our study revealed slight male predominance. A slight male predominance in GIST incidence was reported in Taiwanese study but the Chinese survey showed equal rates of incidence similar to the Italian hospital study [26]- [28]. The Taiwanese data demonstrated younger age and female sex as independent predictors of better survival.…”

Clinical presentation, management and outcomes of gastrointestinal stromal tumors

“…In a Middle East population, GIST occurred in males over 40 years of age in most of the cases [15]. A slight male predominance in GIST incidence was reported in Taiwanese study but the Chinese survey showed equal rates of incidence similar to the Italian hospital study [4,10,13]. The Taiwanese data demonstrated younger age and female sex as independent predictors of better survival (Fig.…”

“…females [13]. Sorour et al [1] reported the mean age of patients at diagnosis of GIST was nearly 50 years, whereas Miettinen et al [14] revealed GISTs occurs rarely below 40 years and very unusual in children.…”

Clinicopathological Features and Outcomes of Gastrointestinal Stromal Tumours in Oman

“…A comparative analysis of regional and international research concerning GIST cases is presented in Table 3. [13][14][15][16][18][19][20][21][22] In the current study, the median age at presentation was 55.5 years. While this finding is consistent with other studies published from countries in South East Asia and the Middle East, it varies compared to studies from the UK and Italy.…”