Gastrointestinal Stromal Tumours (GIST): Indian Experience of Rare Malignancy
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ORIGINAL ARTICLE
Gastrointestinal Stromal Tumours (GIST): Indian Experience of Rare Malignancy Kanuj Malik 1 & Ramakrishnan A. Seshadri 1,2
&
Shirley Sundersingh 3 & Manikandan Dhanushkodi 4
Received: 12 September 2019 / Accepted: 7 May 2020 # Indian Association of Surgical Oncology 2020
Abstract GISTs are rare tumours of the GI tract arising from the intestinal cells of Cajal. Though various risk stratification systems have been proposed, none has been universally accepted. We audited the survival and recurrence patterns in our patients and evaluated clinicopathological features to identify prognostic factors affecting survival. We conducted a retrospective analysis of patients treated at our hospital from 1999 to 2012. Patient variables, clinicopathological factors and treatment variables were collected. Sixty-three patients were evaluated and treated at our institute of which 38 were non-metastatic. The most common site of origin was the stomach. On univariate analysis, presence of metastasis, male gender, high mitotic rate, non-gastric primary and epithelioid histology were significantly associated with poor overall survival. Tumour size > 10 cm, mitotic rate > 10/50 hpf and presence of necrosis significantly affected disease-free survival for non-metastatic patients. Multivariate analysis showed higher mitotic rate and non-gastric primary to correlate with worse outcome. In our experience, a high mitotic rate and non-gastric primary independently predicted a poor prognosis in GIST. Keywords Gastrointestinal stromal tumour . Prognosis . Survival
Introduction Gastrointestinal stromal tumours (GIST) are rare tumours of the gastrointestinal tract, which were initially grouped together with other neoplasm as “stromal tumours” [1]. The discovery of various diagnostic markers including mutational analysis for KIT protein (CD 117) and PDGFR and expression of protein kinase C and DOG1 led to their separation from other stromal tumours. The treatment of GIST has undergone a paradigm change over the last decade which has significantly improved survival; hence, studies with long-term follow-ups
are required. Multiple retrospective studies have been conducted to find out prognostic factors affecting survival; however, no uniform staging system has been formulated, probably due to rarity of the disease. Furthermore, the data from the Indian subcontinent is scarce. There are limited series which have reported survival and analysed prognostic factors with very few studies having long-term follow-ups. We conducted a review of patients treated at our centre to evaluate the prognostic factors, survival and recurrence patterns in our patients.
Materials and Methods * Ramakrishnan A. Seshadri [email protected] 1
Department of Surgical Oncology, Cancer Institute (WIA), Chennai 600020, India
2
Department of surgical oncology, Cancer Institute (WIA), Dr. S. Krishnamurthy Campus, No. 18, Sardar Patel Road, Chennai 600036, India
3
Department of OncoPathology, Cancer Institute (WIA), Chennai 600020, India
4
Department of
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