Abstract
BACKGROUND: To explore overall survival (OS) and GISTs-specific survival (GSS) among cancer survivors developing a second primary gastrointestinal stromal tumors (GISTs). METHODS: We conducted a cohort study, where patients with GISTs after another malignancy (AM-GISTs, n=851) and those with only GISTs (GISTs-1, n=7660) were identified from the Surveillance, Epidemiology, End Results registries (1988-2016). Clinicopathologic characteristics and survival were compared between the two groups. RESULTS: The most commonly diagnosed first primary malignancy was prostate cancer (27.7%), followed by breast cancer (16.2%). OS among AM-GISTs was significantly inferior to that of GISTs-1: 10-year OS was 40.3% vs. 50.0%, (p<0.001); A contrary finding was observed for GSS (10-year GSS: 68.9% vs. 61.8%, p=0.002). In the AM-GISTs group, a total of 338 patients died, of which 26.0% died of their initial cancer and 40.8% died of GISTs. Independent of demographics and clinicopathological characteristics, mortality from GISTs among AM-GISTs patients was decreased compared with their GISTs-1 counterparts (HR, 0.71; 95% CI, 0.59-0.84; p<0.001); whereas OS was inferior among AM-GISTs (HR, 1.11; 95% CI, 0.99-1.25; p=0.085). CONCLUSIONS: AM-GISTs patients have decreased risk of dying from GISTs compared with GIST-1. Although another malignancy history does not seemingly affect OS for GISTs patients, clinical treatment of such patients should be cautious.
Imatinib Mesylate for Patients With Unresectable or Recurrent Gastrointestinal Stromal Tumors: 10-Year Experience From Vietnam
