ORIGINAL RESEARCH ARTICLE
Effect of clinical and pathological features of gastrointestinal stromal tumors on overall survival and prognosis: Single center experience
Received Date : 05 Jul 2019
Accepted Date : 19 Oct 2019
Available Online : 31 Oct 2019
Doi: 10.1016/j.jons.2019.10.003 - Article's Language: EN
J Oncol Sci 5 (2019) 73-79
Aim: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the
gastrointestinal tract.We aimed to evaluate the clinicopathological features of the patients in Thrace and
improve our management.
Material and Method: In this retrospective study, 68 patients with a diagnosis of GIST referred to Trakya
University Medical School Hospital between 1997 and 2015 were evaluated.
Results: The most common symptom was abdominal pain (38.2%) and the location was small-intestine
(42.6%). Large masses had higher metastasis and relapse rate. The mean tumor size with relapse was
11.8 ± 3.8 cm meanwhile it was 6.5 ± 3.0 cm in non-relapsed patients (p ¼ 0.01). The mean size of the
tumor was 13.5 ± 4.4 in the metastatic group although this data was 8.8 ± 4.7 cm in the non-metastatic
group (p ¼ 0.01). With necrotic tumors, mitotic rate and size were higher. The mean mitosis count was
21.0 ± 3.6 in necrotic tumors and 7.2 ± 9.9 in non-necrotic tumors (p ¼ 0.005). The mean size was
10.8 ± 5.0 cm in necrotic tumors and 5.6 ± 3.0 cm in non-necrotic tumors (p ¼ 0.009). According to AFIP
criteria, most of the patients were in the high-risk group (57.4%). Overall survival (OS) was longer in nonsmokers
and non-drinkers. Median OS was 80.16 months in non-smoker group (95% CI, 27.83e132.49)
and 24.64 months (95% CI, 15.49e33.78) in the smoker group (p ¼ 0.001). The median OS was 80.09
months in the non-drinker group (95% CI, 13.99e146.20) and 24.64 months (95% CI, 13.18e36.10) in
drinker group (p ¼ 0.05). Median OS in stomach GIST was 41.39 months, in small-intestine were 80.09
months and in the colon were 35.68 months (p ¼ 0.032). Patients underwent surgery had longer overallsurvival.
Median OS was 80.09 months in patients undergone surgery and 16.98 months in patients had
not been operated (p ¼ 0.001). Overall survival was longer in GIST with mitotic rate <5/50HPF than with
>5/50HPF. Median OS was 80.16 months in patients who had less than 5 mitosis and 39.22 months in
higher mitotic rate (95% CI, 31.58e46.87) (p ¼ 0.034). Overall survival was shorter in GIST with Ki-67 > 5%
than with 5%>. Median OS was 80.16 months (95% CI, 28.80e49.65) in <5% and 39.22 months (95% CI,
28.80e49.65) in 5% Ki-67 (p ¼ 0.004).
Conclusions: The most important factors about the survival and prognosis of GIST are location, size,
mitotic rate, Ki-67, necrosis and surgery status. Using tobacco/alcohol may be related to survival. This
study should be further investigated with extensive data.
Keywords: GIST; Overall-survival; Prognosis