MORPHOLOGIC SPECTRUM AND CLINICO-PATHOLOGICAL CORRELATION OF GASTROINTESTINAL STROMAL TUMOURS: AN EXPERIENCE OF SIX YEARS AT A TERTIARY CARE HOSPITAL.
Objective: The objective of this study was to determine the morphologic spectrum and risk category of gastrointestinal stromal tumour (GIST) and compare with overall patient survival.
Materials and Methods: It is a descriptive observational study. The study was carried at Shifa International Hospital, Islamabad. Duration of the study was from January 2009 to January 2015. A total of 31 patients with the diagnosis of GIST were included, irrespective of age and gender. Data were retrieved from laboratory information system.
Results were analysed by statistical software, Statistical Package of the Social Sciences. Morphologic type, site of tumour, risk category and overall survival were determined and mean, standard deviation, frequencies and percentages were calculated for age site and risk category.
Results: Of 31 patients, 21 (67.7%) were male and 10 (32.3%) were female. Site of tumour was as follows: Gastric 13 (41.9%), extra visceral 6 (19.4%), small intestine 9 (29.0%), rectum 2 (6.5%) and pancreas 1 (3.2%). According to risk categorisation, one was categorised as (3.2%) very low risk, 3 (9.7%) low risk, 5 (16.1%) intermediate risk and 22 (71%) high risk. Follow-up was available in 21 patients. 7 patients (22.5%) lost to follow-up. 8 (25%) had recurrence and 4 (12.9%) died.
Conclusion: Majority of cases diagnosed at our centre were gastric in origin followed by small intestine, and as per risk categorisation, most were high risk. Patient survival with high-risk tumours was dismal.
Key words: Gastrointestinal stromal tumour, immunohistochemistry, risk categorisation
Bashir U, Qureshi A, Khan HA, et al. Gastrointestinal stromal tumor with skeletal muscle, adrenal and cardiac metastases: An unusual occurrence. Indian J Pathol Microbiol 2011;54:362-4.
Greenson JK. Gastrointestinal stromal tumors and other mesenchymal lesions of the gut. Mod Pathol 2003;16:366-75.
Mucciarini C, Rossi G, Bertolini F, et al. Incidence and clinicopathologic features of gastrointestinal stromal tumors. A population-based study. BMC Cancer 2007;7:230.
Hemmings C, Yip D. The changing face of GIST: Implications for pathologists. Pathology 2014;46:141-8.
Lv M, Wu C, Zheng Y, et al. Incidence and survival analysis of gastrointestinal stromal tumours in shanghai: A population-based study from 2001 to 2010. Gastroenterol Res Pract 2014;2014:834136.
Jones RL. Practical aspects of risk assessment in gastrointestinal stromal tumors. J Gastrointest Cancer 2014;45:262-7.
Katie DL, Ivan D. Evaluating and reporting gastrointestinal stromal tumors after imatinib mesylate treatment. Open Path J 2009;3:53-7.
American Cancer Society. Gastrointestinal Stromal Tumour (GIST). American Cancer Society; 2015. Available from: http:// www.cancer.org cancer. [Last accessed on 2016 Aug 15].
Din OS, Woll PJ. Treatment of gastrointestinal stromal tumor: Focus on imatinib mesylate. Ther Clin Risk Manag 2008;4:149-62.
DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg 2000;231:51-8.
Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: A clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow up. Am J Surg Pathol 2005;29:52-68.
Miettinen M, Monihan JM, Sarlomo-Rikala M, et al. Gastrointestinal stromal tumors/smooth muscle tumors (GISTs) primary in the omentum and mesentery: Clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol 1999;23:1109-18.
Reith JD, Goldblum JR, Lyles RH, et al. Extragastrointestinal (soft tissue) stromal tumors: An analysis of 48 cases with emphasis on histologic predictors of outcome. Mod Pathol 2000;13:577-85.
Qureshi A, Shiyam K, Sinan II, et al. C-kit negative extra intestinal gastrointestinal stromal tumour with no detectable mutations: A rare case. J Solid Tumors 2013;3:25-9.
Call J, Walentas CD, Eickhoff JC, et al. Survival of gastrointestinal stromal tumor patients in the imatinib era: Life raft group observational registry. BMC Cancer 2012;12:90.
ChengY,ZhangZ,ZhuH,etal.Clinicopathologicfeaturesof succinate dehydrogenase-de cient gastrointestinal stromal tumor. Zhonghua Bing Li Xue Za Zhi 2016;45:153-8.
Gao X, Xue A, Fang Y, et al. Role of surgery in patients with focally progressive gastrointestinal stromal tumors resistant to imatinib. Sci Rep 2016;6:22840.
MaghrebiH,ChebbiF,MakniA,etal.Laparoscopicresection of gastric stromal tumours. Tunis Med 2015;93:594-7.
Duman K, Harlak A. Independent prognostic factors and unsettled parameters of resected primary gastrointestinal stromal tumors. Surgery 2016;159:1696-7.
Li J, Zhang H, Chen Z, et al. Clinico-pathological characteristics and prognostic factors of gastrointestinal stromal tumors among a Chinese population. Int J Clin Exp Pathol 2015;8:15969-76.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright and grant the Journal of Cancer & Allied Specialties (JCAS) right-of-first publication. In addition, the work will be simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. This license allows others to share the work in whole or part (for non-commercial purpose), with an acknowledgement of the work’s authorship and initial publication in JCAS.
Furthermore, authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to share their work online or in medical or scientific conferences prior to or during submission process.