ADVERTISEMENT
Prognostic impact of clinicopathological characteristics on gastrointestinal stromal tumors in a Latin population
Background
Of all neoplasms of the gastrointestinal tract, gastrointestinal stromal tumors (GIST) are the least frequent, representing between 1-2% of cases. Historically, they were associated with a poor prognosis, with a mean overall survival of 60 months for the early stage and 19 months for the metastatic stage. With the advent of targeted therapies and surgery, the prognosis for these patients has changed. Objective: To characterize patients with early and metastatic GIST treated at the National Cancer Institute (INCan) from 2001-2019.
Methods
This is a retrolective study, with a follow-up cohort, carried out at the INCan. Demographic, clinical, surgical, pathological, and follow-up variables were recorded. Overall survival (SVG), disease-free (DFS) and progression-free (PFS) curves were constructed with Kaplan-Meier and compared with the log rank method, considering p < 0.05 to be significant.
Results
157 patients were included from January 2001 to December 2019. The median age was 55 years, women predominated (52.9%), and gastric GIST was the most frequent (44.6%). 47.8% of the cases were in an advanced stage, with the liver being the predominant metastatic site (44%). 67.5% were initially treated with surgery, being curative in 81.1%. Of these, 79.2% of the cases had risk factors for relapse. Factors negatively associated with SVG were: male gender (p=0.0065), hypoalbuminemia at diagnosis (p=0.0018), advanced stage (p=0.0005), and not receiving imatinib treatment (p=0.0001). Overall DFS and PFS were 5.3 years and 2.2 years, respectively.
Conclusions
The patients with GIST treated at the INCan present some similarities, but also differences with respect to other cohorts. SVG is influenced by gender, clinical stage, initial treatment, quality of resection, and use of imatinib. Activating mutations in KIT or platelet-derived growth factor receptor alpha (PDGFRA) are currently being analyzed by next-generation sequencing for their prognostic and predictive significance.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
