Clinicopathological Features and Prognosis of Gastrointestinal Stromal Tumor Located in the Jejunum and Ileum

Background: Data about the clinicopathological features and prognosis of gastrointestinal stromal tumors (GISTs) located in jejunum and ileum are lacking. The present study aims to investigate the features and prognosis of jejunal and ileal GISTs based on the Surveillance, Epidemiology, and End Results (SEER) database. Patients and Methods: Cases of jejunal and ileal GISTs were extracted from SEER database. Clinicopathological characteristics and survival data of patients were recorded. The clinicopathological features and prognosis of patients were analyzed. Results: There were 399 male (56.8%) and 303 female (43.2%). The median age was 60 years (17–96). Four hundred and seventy-two tumors were located in the jejunum (67.2%) and 230 tumors in the ileum (32.8%). The median tumor size was 7.0 cm (0.5–90). The 5-, 10-, and 20-year disease specific survival (DSS) was 84.4, 71.2, and 54.2% respectively. Clinicopathological features were comparable between tumors located in the jejunum and ileum (all p > 0.05) except gender and tumor size (both p < 0.05). Jejunal GISTs, rather than ileal GISTs (p = 0.043), were commonly found in the males. The tumor size of jejunal GISTs was smaller than that of ileal GISTs (p = 0.010). The DSS of jejunal GISTs was comparable to that of ileal GISTs (p = 0.269). Conclusions: Jejunal GISTs were more common than ileal GISTs. The prognosis was comparable between jejunal and ileal GISTs.

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Clinicopathological Features and Clinical Outcomes of Primary Hepatic Gastrointestinal Stromal Tumors: Evaluation of a Pooled Case Series

10.21203/rs.3.rs-66778/v1 ◽

2020 ◽

Author(s):

Xing Xu ◽

Guoliang Zheng ◽

Zhichao Zheng

Keyword(s):

High Risk ◽

Mitotic Index ◽

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Multivariable Analysis ◽

Case Series ◽

Risk Classification ◽

Clinicopathological Features ◽

Stromal Tumors ◽

Gastric Gists

Abstract Background: Due to the extremely rare incidence, data of clinicopathological features and prognosis of primary hepatic gastrointestinal stromal tumors (GISTs) is limited. Methods: 36 cases of hepatic GISTs were from the literature, PUBMED, EMBASE, China National Knowledge Infrastructure and WANFANG DATA, and 1 case came from our center. Clinicopathological features and outcomes were analyzed between 37 hepatic GISTs and 254 gastric GISTs from our center. Results: A majority of hepatic GISTs exceeded 5 cm (83.7%), displayed mixed density (69.4%) and spindle morphology (74.2%) and were classified as high risk (91.4%). Larger tumors of hepatic GISTs were likely to display mixed lesion and tumors with mixed lesion were prone to be classified as high risk. In comparisons to gastric GISTs, hepatic GISTs differed from gastric GISTs in tumor size, main symptoms, histologic type, mitotic index, CD34 expression, NIH risk classification. In patients with hepatic GISTs, 5-year DFS and DSS rates were 19.4% and 53.7%, which were worse than that of gastric GISTs (P＜ 0.001), especially for those with tumor size exceeding 5 cm or mitotic indices exceeding 5/50 HPF (P < 0.001). Multivariable analysis showed location and NIH risk classification were independent prognostic factors for DFS in patients with GISTs, and size and location were significantly associated with DSS. Conclusions: Hepatic GISTs distinguished from gastric GISTs in respect to clinicopathological features and outcomes. Mitotic index exceeding 5/50 HPF or tumor size exceeding 5 cm may be important factor to distinguish hepatic GISTs from gastric GISTs in DFS and DSS.

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Clinicopathological Features and Prognostic Factors of Rectal Gastrointestinal Stromal Tumors

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-012-2086-0 ◽

2013 ◽

Vol 17 (4) ◽

pp. 793-798 ◽

Cited By ~ 8

Author(s):

C. C. Xiao ◽

S. Zhang ◽

M. H. Wang ◽

L. Y. Huang ◽

P. Wu ◽

...

Keyword(s):

Prognostic Factors ◽

Gastrointestinal Stromal Tumors ◽

Clinicopathological Features ◽

Stromal Tumors

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The Effect of Marital Status on Survival of Patients with Gastrointestinal Stromal Tumors: A SEER Database Analysis

Gastroenterology Research and Practice ◽

10.1155/2018/5740823 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Wei Song ◽

Chuan Tian

Keyword(s):

Prognostic Factor ◽

Marital Status ◽

Gastrointestinal Stromal Tumors ◽

Cox Regression ◽

Seer Database ◽

Cancer Specific Survival ◽

Stromal Tumors ◽

Kaplan Meier ◽

Risk Of Cancer ◽

The Impact

Background. Marital status has been reported to be a prognostic factor in multiple malignancies. However, its prognostic value on gastrointestinal stromal tumors (GISTs) have not yet been determined. The objective of the present analysis was to assess the effects of marital status on survival in patients with GISTs. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze 6195 patients who were diagnosed with GISTs from 2001 to 2014. We also use Kaplan-Meier analysis and Cox regression to analyze the impact of marital status on cancer-specific survival (CSS). Results. Patients in the married group had more frequency in white people, more high/moderate grade tumors, and were more likely to receive surgery. Widowed patients had a higher proportion of women, a greater proportion of older patients (>60 years), and more common site of the stomach. Multivariate analysis demonstrated that marital status was an independent prognostic factor for GISTs (P<0.001). Married patients had better CSS than unmarried patients (P<0.001). Subgroup analysis suggested that widowed patients had the lowest CSS compared with all other patients. Conclusions. Marital status is a prognostic factor for survival in patients with GISTs, and widowed patients are at greater risk of cancer-specific mortality.

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Clinicopathological Features and Outcome of Gastrointestinal Stromal Tumors in an Afro-Caribbean Population

Journal of the National Medical Association ◽

10.1016/s0027-9684(15)30122-x ◽

2012 ◽

Vol 104 (1-2) ◽

pp. 72-77 ◽

Cited By ~ 3

Author(s):

Doreen Brady-West ◽

Garfield Blake

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Clinicopathological Features ◽

Stromal Tumors ◽

Caribbean Population

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Long-term Survival among Patients with Gastrointestinal Stromal Tumors Diagnosed after Another Malignancy: A SEER Population-Based Study

10.21203/rs.2.21309/v1 ◽

2020 ◽

Author(s):

Chaoyong Shen ◽

Chengshi Wang ◽

Tao He ◽

Zhaolun Cai ◽

Xiaonan Yin ◽

...

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Population Based ◽

Clinicopathological Characteristics ◽

Second Primary ◽

Primary Malignancy ◽

Clinicopathologic Characteristics ◽

Term Survival ◽

Stromal Tumors ◽

Group A

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.

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Endoscopic Removal of Gastrointestinal Stromal Tumors in the Stomach: A Single-Center Experience

Gastroenterology Research and Practice ◽

10.1155/2019/3087298 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Yingjie Guo ◽

Xue Jing ◽

Jian Zhang ◽

Xueli Ding ◽

Xiaoyu Li ◽

...

Keyword(s):

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Average Length ◽

Risk Classification ◽

Low Risk ◽

Efficacy And Safety ◽

Endoscopic Removal ◽

Moderate Risk ◽

Stromal Tumors ◽

Gastric Gists

Background and Aims. Endoscopic removal of GISTs (gastrointestinal stromal tumors) is recently recognized, but less is known about its efficacy and safety. This study is aimed at assessing the feasibility, clinical efficacy, and safety of the endoscopic removal of gastric GISTs. Patients and Methods. Endoscopic removal (ER) of GISTs was performed in 134 patients at our hospital between January 2015 and January 2019. The clinical features, surgical outcomes, complications, pathological diagnosis, and risk classification were evaluated retrospectively. Results. ER was successful in 131 cases (98%), including 58 by ESD (endoscopic submucosal dissection), 43 by ESE (endoscopic submucosal excavation), 25 by EFTR (endoscopic full-thickness resection), and 5 by STER (submucosal tunneling endoscopic resection). In addition, GISTs of two cases were resected using LECS (laparoscopic and luminal endoscopic cooperative surgery) for the extraluminal and intraluminal growth pattern. The average tumor size was 1.89±1.25 cm (range: 0.5-6.0 cm). Of these patients, 26 cases had a large tumor size (range: 2.0-6.0 cm), and endoscopic removal was successful in all of them. During the procedure, endoclips were used to close the perforation in all cases, without conversion to open surgery. The average length of hospital stay was 5.50±2.15 days (range: 3-10 days). In the risk classification, 106 (79.7%) were of a very low risk, 25 (18.8%) of a low risk, and 2 (1.5%) of a moderate risk. The moderate-risk cases were treated with imatinib mesylate after ER. No recurrence or metastasis was observed during the follow-up period of 23±8 months (range: 3-48 months). Conclusions. The endoscopic treatment is feasible, effective, and safe for gastric GISTs, and individualized choice of approaches is recommended for GISTs.

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Gastrointestinal Stromal Tumors: A “Benign” Tumor with Hepatic Metastasis after 11 Years

Tumori Journal ◽

10.1177/030089169808400117 ◽

1998 ◽

Vol 84 (1) ◽

pp. 78-81 ◽

Cited By ~ 29

Author(s):

Carlo Ballarini ◽

Mattia Intra ◽

Andrea Pisani Ceretti ◽

Francesco Prestipino ◽

Filippo Maria Bianchi ◽

...

Keyword(s):

Surgical Treatment ◽

Hepatic Metastasis ◽

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Cellular Proliferation ◽

Malignant Potential ◽

Mitotic Count ◽

Proliferation Index ◽

Ki 67 ◽

Stromal Tumors

Gastrointestinal stromal tumors (GIST) constitue the largest category of primary non-epithelial neoplasms of the stomach and small bowel. They are characterized by a remarkable cellular variability and their malignant potential is sometimes difficult to predict. Very recent studies, using mitotic count and tumor size as the best determinants of biological behavior, divide GISTs into three groups: benign, borderline and malignant tumors. We report on a male patient who underwent a right hepatectomy for a large metastasis 11 years after the surgical treatment of an antral-pyloric gastric neoplasm, histologically defined as leiomyoblastoma and with clinical, morphological and immunohistochemical features of benignity (low mitotic count, tumor size < 5 cm, low cellular proliferation index). Histological and immunohistochemical analysis of the hepatic metastasis showed the cellular proliferation index (Ki-67) to be positive in 25% of neoplastic cells, as opposed to the primary gastric tumor in which Ki-67 was positive in only 5% of neoplastic cells. In conclusion, although modern immunohistochemical techniques are now available to obtain useful prognostic information, the malignant potential of GISTs is sometimes difficult to predict: neoplasms clinically and histologically defined as benign could metastasize a long time after oncologically correct surgical treatment. Therefore, benign GISTs also require consistent, long-term follow-up.

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