The epidemiology of gastrointestinal stromal tumors in Taiwan, 1998–2008: a nation-wide cancer registry-based study

Abstract

BackgroundTo investigate the incidence of gastrointestinal stromal tumors (GISTs) in Taiwan and the impact of imatinib on the overall survival (OS) of GIST patients.MethodsGISTs were identified from the Taiwan Cancer Registry (TCR) from 1998 to 2008. The age-adjusted incidence rates and the observed OS rates were calculated. Cox proportional hazards models were applied to examine the mortality risk in three time periods (1998–2001, 2002–2004, 2005–2008) according to the application and availability of imatinib.ResultsFrom 1998 to 2008, 2,986 GISTs were diagnosed in Taiwan. The incidence increased from 1.13 per 100,000 in 1998 to 1.97 per 100,000 in 2008. The most common sites were stomach (47-59%), small intestine (31-38%), and colon/rectum (6-9%). The 5-year observed OS was 66.5% (60.3% for men, 74.2% for women, P < .0001). GISTs in the stomach had a better 5-year observed OS (69.4%) than those in the small intestine (65.1%) (P < .0001). The outcome of GIST improved significantly after the more widespread use of imatinib; the 5-year observed OS increased from 58.9% during 1998–2001 to 70.2% during 2005–2008 (P < .0001). Younger age, female sex, stomach location, and later diagnostic years were independent predictors of a better survival.ConclusionsThe incidence of GIST has been increasing in Taiwan, partially due to the advancement of diagnostic technology/method and the increased awareness by physicians. The outcome of GIST has improved significantly with the availability and the wider use of imatinib.

Clinical presentation, management and outcomes of gastrointestinal stromal tumors

“…This finding may reflect the advancement of the modality of diagnosis after 2006. Various epidemiological studies showed the incidence of GIST as 5e20 per million of the population [4,10,11]. The Taiwanese cancer registry-based study reported more than 5% increase in incidence of GIST in ten years [4], likely reflects the advancements in diagnosis of the disease.…”

“…Various epidemiological studies showed the incidence of GIST as 5e20 per million of the population [4,10,11]. The Taiwanese cancer registry-based study reported more than 5% increase in incidence of GIST in ten years [4], likely reflects the advancements in diagnosis of the disease. A 30-year study in Japan also showed similar trend of significant increase in the GIST incidence during the last decade [12].…”

“…CD117, a protein encoded by the c-KIT gene, is an important marker in the diagnosis of GIST. Other markers used are; CD34, vimentin, keratin, smooth muscle actin (SMA) and S100 [4]. The risk of GIST is increasing in people who have inherited the mutation and in some instances GISTs can be found in several members of the same family [6].…”

Meta-analysis for the Association between Overall Survival and Progression-Free Survival in Gastrointestinal Stromal Tumor

“…The annual incidence of GIST may range from 6.8 to 19.7 per million across several countries, including the United States (2,3). This range may be an underestimate due to the challenges of diagnosis and the under-representation of small GIST cases in cancer registries (4).…”

A Call to Action: Intensify the Investigation of Relatively Rare Tumors of the Gastrointestinal Tract

“…The study examined the 5-year survival and showed GIST-specific survival rates of 65 and 79% [3]. A study by Chiang et al [4] from Taiwan showed that the incidence of GISTs in the 2005-2008 period was 1.97/100,000, the median survival being 8.4 years.…”