Author(s): Pornsuksiri K, Chewatanakornkul S, Kanngurn S, Maneechay W, Chaiyapan W,
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Abstract AIM: To review a single institutional experience in clinical management of gastrointestinal stromal tumors (GIST) and analyze for factors determining treatment outcome. METHODS: Clinicopathological data of patients with a diagnosis of GIST who were treated at our institute during November 2004 to September 2009 were retrospectively reviewed. RESULTS: Ninety-nine cases were included in the analysis. Primary tumor sites were at the stomach in and small bowel in 44\% and 33\%, respectively. Thirty-one cases already had metastasis at presentation and the most common metastatic site was the liver. Sixty-four cases (65\%) were in the high-risk category. Surgical treatment was performed in 77 cases (78\%), 3 of whom received upfront targeted therapy. Complete resection was achieved in 56 cases (73\% of operative cases) and of whom 27 developed local recurrence or distant metastasis at a median duration of 2 years. Imatinib was given as a primary therapy in unresectable cases (25 cases) and as an adjuvant in cases with residual tumor (21 cases). Targeted therapy gave partial response in 7 cases (15\%), stable disease in 27 cases (57\%) and progressive disease in 13 cases (28\%). Four-year overall survival was 74\% (95\% CI: 61\%-83\%). Univariate survival analysis found that low-risk tumor, gastric site, complete resection and response to imatinib were associated with better survival. CONCLUSION: The overall outcomes of GIST can be predicted by risk-categorization. Surgery alone may not be a curative treatment for GIST. Response to targeted therapy is a crucial survival determinant in these patients.
This article was published in World J Gastrointest Oncol
and referenced in Journal of Gastrointestinal & Digestive System