Outcome and prognostic factors of primary gastrointestinal stromal tumours following complete surgical resection

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms. Surgical excision is the definitive treatment for primary localized GISTs. Targeted therapy represented by tyrosine kinase inhibitors has clearly improved the survival rates in patients with GISTs. The aim of this study was to identify prognostic factors influencing tumor recurrence and survival after curative resection of primary GISTs.Methods: This study was conducted on thirty seven patients with localized primary GIST who were operated on in the Department of General Surgery. Then completed adjuvant therapy in the medical Oncology Department, Faculty of Medicine; Tanta University Hospital, from March 2016 to August 2017. All patients’ data, clinical presentations, radiological and endoscopic data, surgical procedures, complications, and survival data were collected, reviewed and analyzed.Results: The mean age of the studied cases was 53.62 years. 14 patients were males and 23 patients were females. Eleven patients had performance status 2. Abdominal pain was the most common complaint. 4 patients presented with acute intestinal obstruction. Ileum was the most common site (14 cases) followed by stomach (13 cases). We reported four cases of extra-gastrointestinal stromal tumors (EGISTs). According to the mitotic index in studied cases; sixteen patients had mitotic count ˃5/50 HPF. Surgical excision was done in all cases with histopathologically negative resection margins. Thirty three cases showed good complete response without local recurrence or distant metastasis.Conclusions:Performance status of patients, tumor size and mitotic index were independent prognostic predictors for tumor recurrence or metastasis.