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Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)

(1) Background: The management of gastrointestinal stromal tumors (GIST) has significantly evolved over the last two decades, with the introduction of tyrosine kinase inhibitors (TKI). We aim to report 10 years of experience of GIST management at a regional cancer center in Canada. (2) Methods: We r...

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Autores principales: Alfagih, Abdulhameed, AlJassim, Abdulaziz, Alshamsan, Bader, Alqahtani, Nasser, Asmis, Timothy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600861/
https://www.ncbi.nlm.nih.gov/pubmed/36290839
http://dx.doi.org/10.3390/curroncol29100562
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author Alfagih, Abdulhameed
AlJassim, Abdulaziz
Alshamsan, Bader
Alqahtani, Nasser
Asmis, Timothy
author_facet Alfagih, Abdulhameed
AlJassim, Abdulaziz
Alshamsan, Bader
Alqahtani, Nasser
Asmis, Timothy
author_sort Alfagih, Abdulhameed
collection PubMed
description (1) Background: The management of gastrointestinal stromal tumors (GIST) has significantly evolved over the last two decades, with the introduction of tyrosine kinase inhibitors (TKI). We aim to report 10 years of experience of GIST management at a regional cancer center in Canada. (2) Methods: We retrospectively analyzed the records of 248 consecutive patients diagnosed with GIST between 2011 and 2021. We describe the clinical and pathological data, management, and outcome, including survival. (3) Results: The most common GIST sites were the stomach 63% (156), followed by the small bowel 29% (73). At diagnosis, 83% (206) of patients had localized disease (stage I–III). According to the modified National Institutes of Health consensus criteria (NIH) for GIST, around 45% (90) had intermediate or high-risk disease. Most patients, 86% (213), underwent curative surgical resection. Forty-nine patients received adjuvant imatinib, while forty-three patients had advanced disease and received at least one line of TKI. With a median follow-up of 47 months, the 5-year recurrence-free survival (RFS) rates for very low and low risk were 100% and 94%, respectively, while those for intermediate and high risk were 84% and 51%, respectively. The 5-year overall survival (OS) rates for very low and low risk were 100% and 94%, while intermediate, high risk, and advanced were 91%, 88%, and 65%, respectively. Using the Kaplan–Meier method, there were statistically significant differences in RFS and OS between NIH risk groups, p < 0.0005. In univariate analysis, ECOG, site, mitosis, secondary malignancy, and size were predictors for OS. High mitosis and large size (>5 cm) were associated with worse RFS. (4) Conclusions: Curative surgical resection remains the gold standard management of GIST. Our results are comparable to the reported literature. Further research is needed to explore histology’s role in risk stratification and initiating adjuvant TKI.
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spelling pubmed-96008612022-10-27 Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH) Alfagih, Abdulhameed AlJassim, Abdulaziz Alshamsan, Bader Alqahtani, Nasser Asmis, Timothy Curr Oncol Article (1) Background: The management of gastrointestinal stromal tumors (GIST) has significantly evolved over the last two decades, with the introduction of tyrosine kinase inhibitors (TKI). We aim to report 10 years of experience of GIST management at a regional cancer center in Canada. (2) Methods: We retrospectively analyzed the records of 248 consecutive patients diagnosed with GIST between 2011 and 2021. We describe the clinical and pathological data, management, and outcome, including survival. (3) Results: The most common GIST sites were the stomach 63% (156), followed by the small bowel 29% (73). At diagnosis, 83% (206) of patients had localized disease (stage I–III). According to the modified National Institutes of Health consensus criteria (NIH) for GIST, around 45% (90) had intermediate or high-risk disease. Most patients, 86% (213), underwent curative surgical resection. Forty-nine patients received adjuvant imatinib, while forty-three patients had advanced disease and received at least one line of TKI. With a median follow-up of 47 months, the 5-year recurrence-free survival (RFS) rates for very low and low risk were 100% and 94%, respectively, while those for intermediate and high risk were 84% and 51%, respectively. The 5-year overall survival (OS) rates for very low and low risk were 100% and 94%, while intermediate, high risk, and advanced were 91%, 88%, and 65%, respectively. Using the Kaplan–Meier method, there were statistically significant differences in RFS and OS between NIH risk groups, p < 0.0005. In univariate analysis, ECOG, site, mitosis, secondary malignancy, and size were predictors for OS. High mitosis and large size (>5 cm) were associated with worse RFS. (4) Conclusions: Curative surgical resection remains the gold standard management of GIST. Our results are comparable to the reported literature. Further research is needed to explore histology’s role in risk stratification and initiating adjuvant TKI. MDPI 2022-09-29 /pmc/articles/PMC9600861/ /pubmed/36290839 http://dx.doi.org/10.3390/curroncol29100562 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alfagih, Abdulhameed
AlJassim, Abdulaziz
Alshamsan, Bader
Alqahtani, Nasser
Asmis, Timothy
Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title_full Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title_fullStr Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title_full_unstemmed Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title_short Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center—The Ottawa Hospital (TOH)
title_sort gastrointestinal stromal tumors: 10-year experience in cancer center—the ottawa hospital (toh)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600861/
https://www.ncbi.nlm.nih.gov/pubmed/36290839
http://dx.doi.org/10.3390/curroncol29100562
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