Mitotic Checkpoints and Chromosome Instability Are Strong Predictors of Clinical Outcome in Gastrointestinal Stromal Tumors

PURPOSE: Several studies have reported clinical behavior and chemotherapy resistance in leiomyosarcomas, but these studies did not differentiate between soft tissue leiomyosarcomas (LMS) and malignant gastrointestinal stromal tumors (GIST). Multidrug resistance (MDR) has been associated with the expression of P-glycoprotein (P-gp), multidrug resistance protein (MRP1), and lung resistance protein (LRP). The aim of the present study was to compare LMS and GIST with respect to clinical outcome and MDR parameters. PATIENTS AND METHODS: Clinical outcome was evaluated in 29 patients with a primary deep-seated LMS and 26 patients with a primary malignant GIST. Paraffin-embedded material, available for 26 patients with LMS and 25 with GIST, was used for immunohistochemical detection of P-gp, MRP1, LRP, and c-kit. RESULTS: Mean overall survival (OS) was 72 months for LMS patients and 31 months for GIST patients (P < .05). Metastases occurred in 16 (59%) of 27 assessable LMS patients and in 10 (56%) of 18 assessable GIST patients. LMS predominantly metastasized to the lungs (14 of 16 patients), whereas GIST tended to spread to the liver (five of 10 patients) and the abdominal cavity (three of 10 patients; P < .001). P-gp and MRP1 expression was more pronounced in GIST than in LMS (P < .05): the mean percentage of P-gp expressing cells was 13.4% in patients with LMS and 38.4% in patients with GIST, and the mean percentage MRP1 expressing cells was 13.3% in patients with LMS and 35.4% in patients with GIST. LRP expression did not differ between LMS and GIST. c-kit was expressed in 5% of the LMS patients and in 68% of the GIST patients. CONCLUSION: LMS patients have a better survival than GIST patients, and the metastatic pattern is different. Expression of MDR proteins in LMS is less pronounced than in GIST.

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Tumor response and clinical outcome in metastatic gastrointestinal stromal tumors under sunitinib therapy: Comparison of RECIST, Choi and volumetric criteria

European Journal of Radiology ◽

10.1016/j.ejrad.2013.02.034 ◽

2013 ◽

Vol 82 (6) ◽

pp. 951-958 ◽

Cited By ~ 19

Author(s):

N. Schramm ◽

E. Englhart ◽

M. Schlemmer ◽

M. Hittinger ◽

C. Übleis ◽

...

Keyword(s):

Clinical Outcome ◽

Gastrointestinal Stromal Tumors ◽

Tumor Response ◽

Stromal Tumors

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Factors Affecting Clinical Outcomes in Women with Non-Gastric Gastrointestinal Stromal Tumors

10.21203/rs.2.23458/v1 ◽

2020 ◽

Author(s):

Peng-Hsuan Huang ◽

Hui-Hwa Chen ◽

Wan-Hwa Ting ◽

Yueh-Yi Chen ◽

Ho-Hsiung Lin ◽

...

Keyword(s):

Clinical Outcome ◽

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Tumor Resection ◽

Hazard Ratio ◽

Gastric Gist ◽

Cancer Stage ◽

Bloody Stool ◽

Factors Affecting ◽

Stromal Tumors

Abstract Background: Knowledge of the clinical outcome of women with non-gastric gastrointestinal stromal tumors (GISTs) is important for preoperative and postoperative consultation, especially for gynecologic oncologist. The aim of this study is to elucidate the factors affecting the clinical outcome of women with non-gastric GISTs.Methods: Between January 2000 and October 2019, all consecutive women with non-gastric GIST who underwent surgeries in a tertiary referral center were reviewed.Results: Among 26 women with non-gastric GISTs, eight (31%) women had recurrence or metastasis. Common clinical presentations included abdominal pain/fullness (n=12, 46%) and tarry/bloody stool (n=7, 27%). The primary locations of the tumors included the intestines (n=24) and an undetermined origin (n=2). Five (19%) women were initially admitted to the gynecologic department. Twenty-four (92%) patients underwent laparotomic tumor resection, and 2 (8%) patients underwent laparoscopic tumor resection. The probabilities of recurrence-free survival (RFS) at 60 and 120 months were 65.2% and 55.9%, respectively. Death occurred in seven (26.9%) women. The probabilities of overall survival (OS) at 60 and 120 months were 71.1% and 63.9%, respectively. Cancer stage was the only independent predictor for RFS (hazard ratio=6.00, p=0.007) and OS (hazard ratio=3.88, p=0.04). However, excluding cancer stage, metastasis (hazard ratio=8.74 for RFS, 6.03 for OS) and tumor size (hazard ratio=1.20 for OS) were independent predictors. Tumor size ≥ 13.9 cm was the optimum cut-off value to predict death and had an area under the receiver operating characteristic curve of 0.75 (95% confidence interval=0.53 to 0.98).Conclusions: Non-gastric GIST may mimic gynecologic adnexal tumors. In addition to cancer stage, metastasis and tumor size (especially ≥ 13.9 cm for OS) remain independent predictors for RFS and OS in women with non-gastric GIST. The above findings may be used for consultation.Trial registration: ClinicalTrials.gov NCT04256226

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